Original Article

Fecal bacteriotherapy for ulcerative colitis: Patients are ready, are we?

  1. Stacy A. Kahn MD1,*,
  2. Rita Gorawara-Bhat PhD2,
  3. David T. Rubin MD3

Article first published online: 25 MAY 2011

DOI: 10.1002/ibd.21775

Issue

Inflammatory Bowel Diseases

Inflammatory Bowel Diseases

Volume 18, Issue 4, pages 676–684, April 2012

Additional Information

How to Cite

Kahn, S. A., Gorawara-Bhat, R. and Rubin, D. T. (2012), Fecal bacteriotherapy for ulcerative colitis: Patients are ready, are we?. Inflamm Bowel Dis, 18: 676–684. doi: 10.1002/ibd.21775

Author Information

  1. 1

    University of Chicago, Inflammatory Bowel Disease Center, Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology, & Nutrition, MacLean Center for Clinical Medical Ethics, Chicago, Illinois

  2. 2

    University of Chicago, Department of Medicine, Section of Geriatrics and Palliative Medicine, Chicago, Illinois

  3. 3

    University of Chicago, Inflammatory Bowel Disease Center, Department of, Medicine, Section of Gastroenterology, MacLean Center for Clinical Medical Ethics, Chicago, Illinois

*University of Chicago, Inflammatory Bowel Disease Center, Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology, & Nutrition, MacLean Center for Clinical Medical Ethics, 5841 S. Maryland Ave., MC 4065, Chicago, IL 60637

Publication History

  1. Issue published online: 19 MAR 2012
  2. Article first published online: 25 MAY 2011
  3. Manuscript Accepted: 18 APR 2011
  4. Manuscript Received: 14 APR 2011

Funded by

  • NIH, University of Chicago CTSA K12 Scholars Program. Grant Number: UL1 RR024999
  • Gastrointestinal Research Foundation Associates Board

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Keywords:

  • ethical issues in IBD;
  • ulcerative colitis;
  • microbiology of IBD;
  • complementary and alternative medicine;
  • focus groups;
  • fecal bacteriotherapy

Abstract

Background:

Fecal bacteriotherapy (FB) has been proposed as a safe and effective alternative treatment for a number of gastrointestinal conditions including ulcerative colitis (UC). We performed a qualitative study to explore the attitudes and concerns of adult patients and parents of children with UC regarding FB as a potential treatment.

Methods:

We conducted six focus groups for adult patients with UC and parents of children with UC or indeterminate colitis. Participants were asked about their perceptions of and interest in FB as a treatment for UC. Sessions were recorded, transcribed, and reviewed to identify domains, themes, and major concepts.

Results:

The focus groups included 15 adult patients and seven parents of children with colitis. We identified five major domains pertaining to FB: impressions of treatment, benefits, risks, potential mechanisms, and social concerns. All but one participant expressed interest in FB and several wished it were already available. Participants compared FB to probiotics, felt it was “natural,” easier than current therapies, and with donor screening would be safe. Although initial distaste and the “yuck factor” were uniformly mentioned, these concerns were outweighed by perceived benefits.

Conclusion:

This is the first study to examine important ethical and social issues surrounding FB as a treatment for UC. Given adequate supporting research, donor selection, and screening, adult patients and parents of children with UC will consider FB and are eager for it to become available. These findings have important implications for future microbiome-based treatments. (Inflamm Bowel Dis 2011;)

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