EXPLORING THE THERAPEUTIC POTENTIAL OF FECAL MICROBIOTA TRANSPLANTATION IN INFLAMMATORY BOWEL DISEASE

Abstract

Background: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic, relapsing inflammatory disorder of the gastrointestinal tract associated with dysbiosis of the gut microbiota. Fecal microbiota transplantation (FMT) has emerged as a microbiome-based therapeutic approach aimed at restoring a healthy microbial ecosystem.

Methods: A narrative review was performed, incorporating recent randomized controlled trials, cohort studies, and meta-analyses published in peer-reviewed journals. The review focused on studies investigating FMT as a therapeutic approach for inducing or maintaining IBD.

Results: Originally validated for recurrent Clostridioides difficile infection, FMT has shown promising results in IBD, particularly in inducing clinical and endoscopic remission in patients with active UC. Evidence suggests that treatment response is influenced by factors including donor microbiota composition, disease severity, baseline microbiome of recipients, and administration protocols. Despite encouraging outcomes, heterogeneity in study design, stool preparation, delivery methods, and treatment schedules limits definitive conclusions. Moreover, the efficacy of FMT for maintenance of remission in UC or induction and maintenance of remission in CD remains uncertain. Safety data are generally favorable in the short term, though long-term risks and standardized procedural protocols require further investigation.

Conclusions: Overall, FMT offers a unique strategy to modulate gut microbial composition and investigate causal relationships in IBD pathogenesis, but well-designed, large-scale studies are needed to establish optimized protocols, long-term efficacy, and safety across diverse patient populations.