Fecal Transplant May Be Key Treatment Option For Patients With Ulcerative Colitis

One in four patients with ulcerative colitis saw significant symptom improvement following a fecal microbiota transplantation, according to the results of a recent clinical trial. What’s more, the patients showed a substantial improvement in the health of their intestinal lining, without the need to take steroid medications.

Ulcerative colitis is a member of the inflammatory bowel group of diseases, which are thought to be caused by a recurring immune response. This inappropriate immune reaction causes the large intestine to become inflamed, resulting in symptoms such as diarrhea, abdominal pain and rectal bleeding.

Approximately 238 in every 100,000 adults in the US suffer from ulcerative colitis, according to statistics from the Centers for Disease Control and Prevention (CDC). While there is no cure for the condition, previous research suggests that the health of the gut microbiota may be important in managing the disease.

A fecal transplant involves collecting fecal matter from a person with healthy gut microbiota, and introducing that material into a person with ulcerative colitis. Before transplantation, the material is screened, processed and prepared, to ensure the patient is receiving an appropriate sample. Techniques such as colonoscopy, endoscopy and enema, can all be used for the fecal transplant procedure.

To test the effectiveness of fecal transplants in patients with ulcerative colitis, Dr. Sudarshan Paramsothy, a gastroenterologist from the University of New South Wales, in Australia, and his team, recruited a total of 81 patients with the condition. The randomized clinical trial included 41 patients who received the fecal transplant, and 41 participants who received the placebo.

All of the patients involved in the study were unresponsive to traditional non-biologic therapies. The patients received the initial fecal transplant through a colonoscope, and were instructed to perform enemas five days per week for a period of eight weeks.

According to the researchers, 27 percent of the patients who received a fecal transplant, met the two main goals of the study. These patients reported an absence of ulcerative colitis-associated symptoms, and their colons showed signs of healing. In the placebo group, only 8 percent of patients reached these goals.

“Our study is the first multi-centered trial that uses an intense therapy of fecal microbiota transplantation infusions, 40 over 8 weeks, and has been able to show definitively that fecal microbiota transplantation is an effective treatment for ulcerative colitis,” said Paramsothy. “By using fecal microbiota transplantation, we aim to treat the underlying cause of ulcerative colitis instead of just its symptoms, as opposed to the majority of therapies currently available.”

As the long-term effects of fecal transplants are unknown, some experts are expressing concern over the safety of the procedure. They say that the fecal transplant could potentially transmit pathogenic agents, and that changes in the gut microbiota could have previously-unknown disease-causing effects.