S1941 Management of Inflammatory Bowel Diseases and Role of Fecal Microbiota Transplantation: A Narrative Review of Clinical Trials

Introduction: Fecal microbiota transplantation (FMT) is a promising approach for managing inflammatory bowel diseases (IBD). This narrative review explores and discusses fourteen studies from clinical trials conducted between 2015 and 2024 with 326 participants. Methods: A thorough literature search was done. The focus was to find clinical trials and studies on fecal microbiota transplantation (FMT) for treating Inflammatory Bowel Diseases (IBD), such as ulcerative colitis and Crohn’s disease. The databases PubMed, Science Direct, EMBASE, Cochrane, Web of Science, and Google Scholar were used, spanning publications from January 2015 to September 2024. Key search terms like “fecal microbiota transplantation,” “IBD,” “FMT,” “inflammatory bowel disease,” “ulcerative colitis,” and “Crohn’s disease” were utilized, combined using Boolean operators (AND, OR) for effective results. Filters helped limit the search to human trials, especially clinical and randomized controlled trials. Beyond the database search, references within relevant articles were manually checked to locate other qualifying studies. Results: Dysregulation of the microbiome plays a key role in the cause of inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) has shown several promising treatment options in patients with IBD (ulcerative Colitis and Crohn’s disease) that are superior to standard therapy with the ultimate goal of correcting the underlying dysbiosis. We included 14 studies with 326 total participants conducted between 2015 and 2024. Study designs varied from prospective single-center trials to double-blinded and randomized clinical trials (RCT). Participants had a wide age range. Donor samples were mostly healthy unrelated patients. FMT administration routes ranged from nasogastric access with minimally invasive techniques to invasive colonoscopy and endoscopy procedures requiring downtime and anesthesia. Conclusion: The general safety profile of the procedure was favorable in most of the studies, with mild adverse effects observed. Therapy success depends on several factors, including donor microbiome, baseline disease severity, and administration frequency. The efficacy and safety of fecal microbiota transplantation in managing IBD prove its utility, especially as an alternative to conventional treatment regimens. However, adequately powered, multicenter randomized clinical trials are needed to substantiate the extent to which these factors influence the clinical outcomes of FMT.