Fecal Bacterial (Microbial) Transplantation (FMT) Statement

July 11, 2013

CCFA is hopeful for the benefits of FMT.  There are fourprospective clinical trials evaluating the efficacy of fecal transplant (see www.clinicaltrials.gov), and will wait for the results of these trials. CCFA supports the ongoing microbiota studies to evaluate the benefits of introducing good bacteria. Through CCFA’s Microbiome Research Project, we are in the process of identifying what these bacteria are, what are the advantageous products they make, and how best to introduce these in patients (probiotic, pill, enema, etc) which may be more palatable than FMT.  Learn more about the micrbiome project at: http://www.crohnscolitisfoundation.org/research/current-research-studies/microbiome-initiative.html.

CCFA has adopted a position on FMT which states “Clostridium difficile infection can occasionally be very difficult to eliminate and usually requires the administration of more antibiotics.  In cases where antibiotic treatment fails, use of fecal microbial transplantation has been implemented... A more challenging question is whether fecal microbial transplantation can be a treatment for inflammatory bowel disease, in the absence of Clostridium difficile infection. It is known that the gastrointestinal microbiota of inflammatory bowel disease patients contains different bacteria from that of people without IBD or those with IBD in remission. These observations suggest that FMT may be a possible treatment for IBD.  There have been, however, no definitive, good quality research studies.   Only small case series have been reported suggesting that FMT may be beneficial for treatment of active IBD but there is concern that the results may have been biased by the low quality of the study methods utilized.  It should also be noted that unlike for C. difficile where a single treatment may be effective, in IBD patients, maintenance treatment with multiple coursed of FMT may need to be considered.  Therefore, treatment of Crohn’s disease or ulcerative colitis with FMT should be considered experimental and only performed as part of a properly designed and supervised research trial."