Fecal transplants are an unregulated treatment that caused major flares in crohn's disease patients in multiple studies.the prime cause of crohns is suspected to be lower microbiome diversity which Fecal Microbiota Transplants aim to correct.
I'm aware of the variety of reports on FMT, both the successes and the failures.Fecal transplants are an unregulated treatment that caused major flares in crohn's disease patients in multiple studies.
The fecal stream is a major contributor to inflammation in crohn's disease:
(1) Early lesions of recurrent Crohn's disease caused by infusion of intestinal contents in excluded ileum.
(2) Effect of faecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum.
(3) Role of the faecal stream in the maintenance of Crohn's colitis.
Fecal transplants are no longer performed on crohn's disease patients in the West, lest doctors want to open themselves up to lawsuits.
"Fecal microbiota transplant for Crohn disease: A study evaluating safety, efficacy, and microbiome profile
Department of Medicine, University of California San Francisco
''We performed a prospective, open-label, single-center study. Ten CD patients underwent FMT and were evaluated for clinical response (defined as decrease in Harvey-Bradshaw Index score ≥3 at one month post-FMT) and microbiome profile (16S ribosomal RNA sequencing) at one month post-FMT.
The study was halted prematurely because of a presumed CD flare in two patients within a few days of undergoing FMT.
The first patient was a 37-year-old woman with colonic CD who had been diagnosed 10 years prior to enrollment in this trial. Her previous therapies included mesalamine and steroids. She was not on any therapy at the time of FMT. Within a few days of the procedure, she developed worsening abdominal pain and diarrhea. Her fecal calprotectin increased from 475 to >2000 µg/g. CRP increased from 2 to 15.5 mg/l and HBI increased from 3 to 16.
The second patient was a 32-year-old woman with colonic CD. She had been diagnosed 16 years prior to enrollment in the study. She had previously failed adalimumab and infliximab (responded initially with subsequent loss of response) and was on certolizumab at the time of FMT. She had required courses of steroids on several occasions but none in the last year prior to FMT. The day following FMT, this patient experienced increased abdominal pain and diarrhea severe enough to require inpatient admission for intravenous hydration and steroids. Her HBI increased from 11 to 13 post-FMT. CRP increased from 18.3 to 33.1 mg/l.
In this prospective, open-label study of FMT in CD, 30% of patients achieved the primary outcome of improvement of HBI ≥3 points one month post-FMT; however, there was no significant improvement in objective measures of inflammation such as fecal calprotectin and SES CD score.
Two patients in this cohort experienced adverse events requiring escalation of therapy within a few days of FMT that prompted early termination of the study.
Conclusions
Single-dose FMT in this cohort of CD patients showed modest effect and potential for harm''