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The Current Landscape and Lessons from Fecal Microbiota Transplantation for Inflammatory Bowel Disease: Past, Present, and Future

Allegretti, Jessica MD, MPH*,†; Eysenbach, Lindsay M. BA‡,§; El-Nachef, Najwa MD; Fischer, Monika MD, MSc; Kelly, Colleen MD**; Kassam, Zain MD, MPH

doi: 10.1097/MIB.0000000000001247
Clinical Review Articles

Abstract: Fecal microbiota transplantation (FMT) has changed the standard of care for Clostridium difficile infection. However, there is limited data focusing on efficacy and safety profile of FMT in patients with C. difficile infection with underlying inflammatory bowel disease (IBD), including the risk of IBD flare. Recently, there is also emerging evidence supporting the role of FMT to treat IBD including promising randomized trials in ulcerative colitis. However, with heterogeneity across these studies, the clinical application of this emerging therapy has yet to be fully elucidated. Here, we aim to review the current landscape of this rapidly developing field, mapping the efficacy and safety of FMT (1) to treat C. difficile infection in patients with IBD, (2) to treat underlying IBD, and (3) outline ongoing clinical trials and the future of the microbiome space.

Article first published online 29 August 2017.

*Harvard Medical School, Boston, Massachusetts;

Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts;

OpenBiome, Somerville, Massachusetts;

§School of Medicine, Yale University, New Haven, Connecticut;

Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California;

Indiana University School of Medicine, Division of Gastroenterology, Department of Medicine, Indianapolis, Indiana; and

**Warren Alpert Medical School of Brown University, Miriam Hospital, and Lifespan Hospital System, Providence, Rhode Island.

Address correspondence to: Jessica Allegretti, MD, MPH, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115 (e-mail:

The authors have no conflict of interest to disclose.

J. Allegretti and L. M. Eysenbach contributed equally.

C. Kelly and Z. Kassam are joint senior authors.

Received June 06, 2017

Accepted July 03, 2017

© Crohn's & Colitis Foundation
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