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Broad and learned
clinical background

Gut Reactions #2 – is faecal transplant an effective treatment option for ulcerative colitis (UC)?

Although traditionally considered fringe therapy, and perhaps an unattractive last resort to treat Clostridium difficile (a bacterial infection that can affect the digestive system), faecal microbiota transplant (FMT) has experienced a surge in interest and popularity, both in clinical practice and research, over the past two to three years. FMT, also known as faecal transplant, is a process whereby healthy stool (i.e. faecal matter, which harbors a positive community of microorganisms or bacteria) is transplanted from a healthy donor to a patient. There are various methods that this can be achieved: via endoscopy, nasogastric tubing, or the ingestion of pills. The idea behind FMT is that ‘unhealthy’ or unbalanced communities of bacteria, which are present in conditions ranging from SIBO (small intestine bacterial overgrowth), to IBS and UC, could be rectified and ‘flushed out’ by introducing healthy colonies of bacteria. Although FMT has not yet been approved as a treatment option by the NHS, it has been approved for research trials. In a recent study (Gastroenterology 2015;149:102-109), FMT was seen to induce remission in a significantly greater percentage of patients with active UC than placebo, with no difference in adverse events. This appears to demonstrate the potential benefits of this treatment option. Whilst the general consensus on FMT currently is not clear, and there are several conflicting studies, it would not be surprising to see this low-cost and relatively controversial treatment option continue to increase in popularity in the coming years.

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