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Systematic review: faecal microbiota transplantation in the management of inflammatory bowel disease
Author(s) -
Anderson J. L.,
Edney R. J.,
Whelan K.
Publication year - 2012
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2012.05220.x
Subject(s) - medicine , inflammatory bowel disease , colonoscopy , randomized controlled trial , transplantation , gastroenterology , disease , systematic review , crohn's disease , enema , medline , colorectal cancer , cancer , political science , law
Summary Background 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. Aim To undertake a systematic review of FMT in patients with IBD . Methods 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 . Results 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). Conclusions 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.