Author information

1 Department of Internal Medicine and Gastroenterology, Policlinico Agostino Gemelli, Università Cattolica del Sacre Cuore, Rome, Italy; Department of Medicine and Gastroenterology, Trinity College Dublin, Dublin, Ireland. grainneholleran@gmail.com.

2 Department of Internal Medicine and Gastroenterology, Policlinico Agostino Gemelli, Università Cattolica del Sacre Cuore, Rome, Italy.

3 Department of Medicine and Gastroenterology, Trinity College Dublin, Dublin, Ireland.

Abstract

Fecal microbiota transplantation (FMT) is the transplantation of microbial gut contents from a healthy individual into the gastrointestinal tract of a person with a disease, with a view to increasing the recipient's gut microbial diversity and bacterial richness and restoring microbial homeostasis. FMT has been proven to be a safe and effective treatment for Clostridium difficile infection (CDI) and it is now a recommended treatment for recurrent or refractory infection. FMT is not currently recommended for use outside of CDI due to concerns regarding outcome and safety; however, several case series and randomized controlled trials have described its use in a research environment for a few gastrointestinal conditions related to intestinal dysbiosis including ulcerative colitis (UC), Crohn's disease (CD) and irritable bowel syndrome (IBS). The most successful reports of the clinical efficacy of FMT in gastrointestinal conditions outside of CDI have been in treating UC. We summarize the current literature regarding the use of FMT in UC, including methodology, clinical efficacy and safety concerns, and identify pitfalls and areas for future development. We also describe the available evidence to date on the use of FMT in CD, IBS and other conditions related to intestinal dysbiosi.