Faecal transplant shows promise in ulcerative colitis

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There is some evidence that fecal transplants help people with active ulcerative colitis achieve remission, a Cochrane review found. However, more research is needed for definitive conclusions. A beneficial effect of faecal transplants has already been demonstrated for recurrent Clostridium difficile infections.

Dysbiosis in IBD

An unhealthy composition of gut bacteria (dysbiosis) is thought to play a role in the pathogenesis of inflammatory bowel disease (IBD). Transplanting faeces from a healthy donor could rebalance the microbiome, which could be beneficial for the course of the disease. The Cochrane review lists all studies into the effect of faecal transplantation in ulcerative colitis and Crohn’s disease. This concerns a total of 12 studies involving a total of 550 participants.

Ulcerative colitis

Most research has been conducted in people with ulcerative colitis. 10 studies have found beneficial effects in people with active ulcerative colitis: faecal transplants were associated with higher rates of clinical and endoscopic remission. However, it is still unclear whether the quality of life improves and there is still little data on serious side effects. It is also not yet clear whether faecal transplants contribute to the maintenance of remission, according to 2 studies. Furthermore, these are small studies that have been set up differently. Therefore, it is not yet possible to draw definitive conclusions about the effect of fecal transplants in ulcerative colitis, say the authors.

Crohn’s disease

Only 1 study has been conducted on the effect of fecal transplants in people with Crohn’s disease. This study looked at maintenance of remission and the evidence for this is not convincing, the authors conclude.

Clostridium difficile

There is sufficient evidence for faecal transplants for effective treatment of recurrent infections with Clostridium difficile, according to another Cochrane review, which was published simultaneously. It lists 6 studies among a total of 320 participants. After a faecal transplant, 77 percent did not get a reinfection in an 8-week period, compared to 40 percent of those treated with antibiotics alone.

Sources: Medical Contact and Cochrane Library

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