Successful treatment of chronic Pouchitis utilizing fecal microbiota transplantation (FMT): a case report

Fang, Shuyang; Kraft, Colleen S.; Dhere, Tanvi; Srinivasan, Jahnavi K.; Begley, Beth; Weinstein, David M.; Shaffer, Virginia

doi:10.1007/s00384-015-2428-y

Cited by 48 publications

(34 citation statements)

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“…Zur lokalen Therapie mit Tacrolimussuppositorien gibt es Einzelfallberichte. Die Datenlage zum Effekt einer FMT bei Pouchitis ist für eine Empfehlung noch unzureichend und konnte keine Remissionsinduktion zeigen [674,675].…”

Section: Hintergrundunclassified

Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

2018

Z Gastroenterol

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This guideline provides evidence-based key recommendations for diagnosis and treatment of ulcerative colitis and upgrades the 2011 version. The guideline was developed by an interdisciplinary team of gastroenterologists, surgeons, pathologists, nutrition experts, and patient support groups under the auspice of the German Society for Gastroenterology and Metabolic Diseases. The guideline used structural S3 consensus-based methodology and includes statements on clinical practice, prevention, infectiological problems, surgery and nutrition.

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Section: Hintergrundunclassified

Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

2018

Z Gastroenterol

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“…Success has been reported in individual patients [48] but a small case series of FMT via nasogastric tube showed no clinical effect [49] . Due to the limited data of FMT in pouchitis, no conclusions can be drawn.…”

Section: Crohn's Disease and Pouchitismentioning

confidence: 99%

Any Future for Fecal Microbiota Transplantation as Treatment Strategy for Inflammatory Bowel Diseases?

Kump

Högenauer²

2016

Dig Dis

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Fecal microbiota transplantation (FMT) is a novel therapeutic procedure aiming at restoring a normal intestinal microbiota by application of fecal microorganisms from a healthy subject into the gastrointestinal tract of a patient. FMT is the most effective treatment for recurrent Clostridium difficile infections (CDI). These infections also occur in patients with inflammatory bowel diseases (IBDs), where case series demonstrated a successful treatment of CDI by FMT in 83-92% of patients. The effect of FMT on the activity of IBD has mainly been investigated in ulcerative colitis (UC) patients, including 3 randomized controlled trials. So far, 2 randomized controlled trials showed a superiority of FMT compared to placebo in inducing remission in UC, while 1 study found no significant difference to placebo. The variation in response to FMT between these studies as well as in the uncontrolled trials might be explained by many differences in the way of FMT application, patient pretreatment and patient and donor selection. The data for the use of FMT in Crohn's disease and pouchitis are sparse; currently, no conclusion can be drawn regarding the effectiveness of FMT in these indications. It needs to be noted that cases of IBD activation after FMT have been reported. So far, FMT can only be recommended to be used for the treatment of concomitant CDI in IBD in clinical practice. For treating IBD irrespective of CDI, FMT should be only used in clinical trials. Current forms of FMT, especially protocols using repeated application, are very time and personnel consuming. Future trends are the use of defined stable microbiota preparations, in particular oral preparations, which will enable better and larger controlled trails for investigating FMT in IBD.

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“…Meanwhile and with increasing numbers of respective randomized and controlled trials, the smoke has been lifted and a differential picture emerges, at least for IBD: FMT transplantation appears to be effective in ulcerative colitis, especially with induction [85] or maintenance of remission [86], while in Crohn’s Disease, less effect was found [87, 88]. Another potential application is pouchitis [89, 90]. During these studies, a number of mediators of treatment success were identified, among them the donor, the route of administration of the stool transplant, and others [91, 92].…”

Section: Fmt In Fbdmentioning

confidence: 99%

Dysbiosis in Functional Bowel Disorders

Enck¹,

Mazurak²

2018

Ann Nutr Metab

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Functional bowel disorders (FBD) resemble a group of diseases of the gastrointestinal (GI) tract that are without a clear pathogenesis; the best known is probably the “irritable bowel syndrome” (IBS). Only recently we have been able to explore the role of the gut microbiota in FBD due to progress in microbiological analytic techniques. There are different ways to explore the role of the gut microbiota and its dysbiosis in FBD. Comparison of the microbial composition in a group of patients with FBD, for example, with IBS to a group of healthy volunteers is one way. Studies have shown that the microbiota in FBD is different from that of healthy controls, but the recorded differences are not necessarily specific for FBD, they may also occur in other diseases. Another approach to explore the role of the gut microbiota in FBD is to challenge the existing “flora” with novel bacteria (probiotics) or with nutritional substrates that stimulate bacterial growth (prebiotics). More than 60 such trials including several thousand patients have been performed in IBS. These studies have produced mixed outcome: some probiotics appear to be better than others, and some appear to work only for a part of the IBS symptoms and not for all. An extreme form of this approach is the transfer of an entire microbiota from 1 healthy person to another, called fecal microbiota transplantation. This has rarely been tested in FBD but is not without risk in benign disorders.

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Successful treatment of chronic Pouchitis utilizing fecal microbiota transplantation (FMT): a case report

Cited by 48 publications

References 0 publications

Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

Any Future for Fecal Microbiota Transplantation as Treatment Strategy for Inflammatory Bowel Diseases?

Dysbiosis in Functional Bowel Disorders

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