Ulcerative colitis is a type of severe, chronic, inflammatory bowel disease. Sufferers experience abdominal cramps and pain, ulcers, and bleeding of the lining of the colon and rectum. Common treatment approaches have included dietary changes and medications but these do not always lead to remission. Other treatments such as fecal transplants are under investigation for their effectiveness with bowel disease like ulcerative colitis. A fecal transplant introduces fecal bacteria from a healthy donor into the affected intestines. This transplant is believed to help the intestine develop a healthy balance of bacteria in the gut which can help the intestine recover and function more effectively. Unfortunately, so far, research has not been clear on the benefits of this transplant for ulcerative colitis.
Researchers from Canada and Massachusetts wanted to investigate the safety and efficacy of fecal microbiota transplantation in patients with active ulcerative colitis. The study, published in Gastroenterology, found that fecal microbiota transplantation had a higher rate of remission compared to placebo in patients with active ulcerative colitis.
About the Study
The randomized trial included 75 adults with active ulcerative colitis. The participants were randomized to a fecal transplant enema or a placebo (water) enema once a week for 6 weeks. At week 7, participants were evaluated using a standard assessment to determine status of ulcerative colitis.
The study found that:
- Remission was reached in 24% of participants in transplant group vs. 5% in placebo group
- Remission was acheived in an additional 5% (4 participants) who continued transplants for an additional 6-12 weeks
- There were no significant differences in adverse events between transplant and placebo group
Among people who received fecal transplantation, disease remission was achieved in:
- 75% of patients with ulcerative colitis for less than 1 year
- 18% of patients with ulcerative colitis for more than 1 year
How Does this Affect You?
A randomized trial is considered the most reliable form of research, but how the research is done will affect its reliability. This trial was stopped early. This makes the results less reliable. Further studies with a greater number of participants will be needed before fecal transplants can be identified as an effective treatment for ulcerative colitis. Continued research will also help determine what bacteria is most beneficial. The identified bacteria may then be cultivated and delivered through other easier methods such as pills.
While this study has shown some promise, it will take more studies to confirm the benefits and potential harms of fecal transplants for ulcerative colitis. If the standard treatments of dietary changes and medications are not managing your ulcerative colitis symptoms, talk to your doctor about other options that may be available. Talk to your doctor about alternative treatments you may be interested in or already trying to make sure they are safe.
RESOURCES
American College of Gastroenterology http://gi.org
Crohn's and Colitis Foundation of America http://www.ccfa.org
References
Crohn's disease in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2015. Accessed July 15, 2015.
Moayyedi P, Surette MG, et al. Fecal microbiota transplantation induces remission in patients with active ulcerative colitis in a randomized controlled trial. Gastroenterology. 2015 Jul;149(1):102-109.