Review article
An overview of fecal microbiota transplantation: techniques, indications, and outcomes

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Gastrointestinal diseases

Current literature on FMT for RCDI predominantly comprises single-center case series and case reports,6, 18, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 a meta-analysis,41 2 systematic reviews,13, 14 and 1 recently published randomized, controlled trial.30 In all, about 92% of patients were cured of their RCDI, with a range of 81% to 100%.6, 18, 20, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 42 The only multicenter long-term follow-up study of patients who underwent colonoscopic FMT for RCDI reported

FMT: Methodology

Although FMT has been practiced intermittently since the 4th century, a standardized protocol rooted in evidence-based practice is still being sought.

FMT: How safe is it?

In the only long-term follow-up study of FMT to date, a 5-medical center, cross-country effort, 77 patients who had had FMT and were followed for more than 3 months experienced and maintained a 91% primary cure rate and a 98% secondary cure rate, the latter defined as cure enabled by use of antibiotics to which the patient had not responded to before the FMT or by a second FMT.43 It is not unusual for transient GI symptoms or altered bowel habits to develop in some patients for several days

Conclusion

FMT is a highly effective and acceptable therapeutic intervention for the treatment of RCDI and may play a role in treating a variety of other GI and non-GI diseases. Donors must be appropriately screened for potentially transmissible diseases before FMT. FMT can be performed via a nasogastric or nasoenteric tube, upper endoscopy, colonoscopy, flexible sigmoidoscopy, or enema. Although there are few studies that directly compare routes of administration, FMT via the upper tract seems to be less

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    DISCLOSURE: The following author disclosed a financial relationship relevant to this publication: Dr Brandt is on the speakers’ bureau of and had received research grants from Optimer Pharmaceuticals. The other author disclosed no financial relationships relevant to this publication.

    See CME section; p. 342.

    E-mail: [email protected].

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