This uncommissioned systematic review was subject to full peer-review.
Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease
Article first published online: 25 JUL 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 36, Issue 6, pages 503–516, September 2012
How to Cite
Anderson, J. L., Edney, R. J. and Whelan, K. (2012), Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 36: 503–516. doi: 10.1111/j.1365-2036.2012.05220.x
- Issue published online: 23 AUG 2012
- Article first published online: 25 JUL 2012
- Manuscript Accepted: 29 JUN 2012
- Manuscript Revised: 26 JUN 2012
- Manuscript Revised: 8 JUN 2012
- Manuscript Received: 10 MAY 2012
The intestinal microbiota is involved in the pathogenesis of inflammatory bowel disease (IBD). Faecal microbiota transplantation (FMT) has been used for the management of IBD as well as infectious diarrhoea.
To undertake a systematic review of FMT in patients with IBD.
The systematic review followed Cochrane and PRISMA recommendations. Nine electronic databases were searched in addition to hand searching and contacting experts. Inclusion criteria were reports (RCT, nonrandomised trials, case series and case reports) of FMT in patients with IBD.
Of the 5320 articles identified, 17 fulfilled the inclusion criteria, none of which were controlled trials. There were nine case series/case reports of patients receiving FMT for management of their IBD, and eight where FMT was for the treatment of infectious diarrhoea in IBD. These 17 articles reported on 41 patients with IBD (27 UC, 12 Crohn's, 2 unclassified) with a follow-up period of between 2 weeks and 13 years. Where reported, FMT was administered via colonoscopy/enema (26/33) or via enteral tube (7/33). In patients treated for their IBD, the majority experienced a reduction of symptoms (19/25), cessation of IBD medications (13/17) and disease remission (15/24). There was resolution of C. difficile infection in all those treated for such (15/15).
Whilst the available evidence is limited and weak, it suggests that faecal microbiota transplantation has the potential to be an effective and safe treatment for IBD, at least when standard treatments have failed. Well-designed randomised controlled trials are required to investigate these findings.