Indications for fecal microbiota transplantation

Dr Paul Moayyedi is a professor in the Division of Gastroenterology at McMaster University, Richard Hunt/AstraZeneca Chair in Gastroenterology, and the inaugural assistant dean of research.

Is fecal microbiota transplantation (FMT) going to be performed for indications other than Clostridium difficile infection (eg, alcoholic steatohepatitis, obesity, inflammatory bowel disease [IBD])?

Paul Moayyedi, BSc, MB ChB, PhD, MPH: I do not know for obesity, as I stated, and same with cirrhosis. I think for IBD the randomized trials in ulcerative colitis are suggestive. I do not think there is enough data yet to say this should be done outside of a clinical trial, but as larger trials are done, if they remain positive then I think this should be an option for patients with ulcerative colitis.

With Crohn disease it goes the same way. There are randomized trials ongoing in that—then maybe for Crohn disease, too. I think if you were to look into the future, the most likely next indications for fecal transplants are going to be ulcerative colitis and then possibly Crohn disease. For everything else I think we are quite a distance off before we get to that stage.