Review of Fecal Transplant in Childhood Gastrointestinal Disorders - Abstract
Fecal microbiota transplant (FMT) has been introduced several decades ago in an
attempt to restore the gut microbial balance. FMT appears to be the most efficient method to effectively change and sustain the gut microbial composition. To this date there have been a great number of reports of success in eliminating recurrent Clostridium difficile infections and restoring the gut microbial profile to resemble that of the healthy donor. The new gut microbiome appears to be stable in the recipients for at least 24 weeks. The efficacy of this “relatively novel” intervention in this difficult to treat population is 90%. This is superior to any other therapeutic modality, yet effective when all other therapeutic avenues have
failed. While over 300 cases have been described in the literature, it has been difficult for the pediatric scientific community to embrace this therapy as there are only sporadic reports in children. FMT has also been used to treat inflammatory bowel disease, especially ulcerative colitis. There have been a number of successful case reports in ulcerative colitis, to suggest control of disease activity and a cure in some cases. However, there has not been uniform success reported for the use of FMT, especially in severe cases recalcitrant to medical therapy. Therefore, there is a strong need to determine the safety and efficacy of FMT in future pediatric randomized controlled studies, especially in inflammatory bowel disease. This review describes the rationale for fecal transplant and provides an update on the current published studies.