Current applications of fecal microbiota transplantation in intestinal disorders

Abstract

Fecal microbiota transplantation (FMT) had been an ancient remedy for severe illness several centuries ago. Under modern medical analysis and evidence‐based research, it has been proved as an alternative treatment for recurrent Clostridium difficile infection and recent randomized control study also showed that FMT could be an adjuvant treatment for inflammatory bowel disease. As we get a better understanding of the relationship between gut microbiota and systemic disease, FMT became a potential treatment to explore. This article summarized procedures such as donor selection, fecal material preparation, transplantation delivery methods, and adverse events. We also review the present evidence about FMT in clinical practice.

The use of fecal microbiota transplantation in the treatment of intestinal diseases

“…Potential donors should be questioned in detail in a medical interview. The donor should be tested serologically towards Amoeba, Treponema pallidum and viruses (HAV, HBV, HCV, HIV, CMV, EBV) and undergo stool screening towards rotavirus, enterovirus, norovirus, adenovirus, astrovirus, Clostridium difficile, Shigella, Salmonella, Campylobacter, Yersinia, Helicobacter pylori, enteropathogenic Escherichia coli, Giardia, Cryptosporidium and others [1,2,4]. Fecal microbiota may be sourced from relatives of candidate donors or from universal donors through stool banks [2,4].…”

“…Before transplantation, a bowel lavage with a colon preparation agent should be applied. The possibilities of delivering fecal material include swallowing oral capsule, administering the material via nasogastric tube, nasoduodenal tube, esophagogastroduodenoscopy, colonoscopy or retention enema [1,4]. Despite the fact that an upper gastrointestinal route can be simply performed, some problems, like uncomfortable feeling, less volume of infusion, and risk of vomiting and aspiration, can occur.…”

“…Fecal microbiota transplantation (FMT) is a process of transferring microflora from the gut of a healthy donor into the digestive tract of a recipient [1]. It is commonly called a stool transplantation and nowadays a lot of research on this topic is coming up.…”

“…Fecal material can be delivered via upper or lower gastrointestinal routes. It is indicated that the human distal gastrointestinal tract consists of more than 10 14 bacteria of about 1000 species [1]. Intestinal microbiome mainly contains species from the phylum Bacteroidetes, Firmicutes, Actinobacteria, and less Proteobacteria.…”

Fecal Transplant: How an Ancient Therapy Is Finding a New Use in Today’s Antibiotic-Resistant Era

“…Prior to this guidance, one review published in 2017 suggested screening for ESBL, but several others did not. [21][22][23] Owing to discrepancies in recommendations, clinical trials had not adopted ESBL as a standard screening metric for donor exclusion criteria, nor had many stool banks. [24][25][26] The guidance provided was a step in the right direction.…”