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Integrating fecal transplant into clinical practice

Abstract:

In recent years, fecal transplant (FT) has garnered increased interest and quick acceptance. Currently, FT is defined as the infusion of feces from healthy individuals into patients with gut dysbiosis, which has been identified as a central component in the pathogeny of numerous gastrointestinal disorders, such as irritable bowel syndrome, inflammatory bowel disease, and Clostridium difficile infections. Moreover, dysbiosis has been proposed as a pathophysiologic element, contributing to multiple chronic non-communicable diseases related to low-grade inflammation such as obesity, diabetes mellitus, cardiovascular disease, cancer, and several neuropsychiatric and autoimmune disorders. Correction of the imbalances in the gut microbiota is the fundamental mechanism of action of FT, via the introduction of microorganisms which may reestablish normal intestinal function. Although the popularity of this alternative is rising, to date, no standardized guidelines have been designed for the preparation or administration of the stool, not the necessary safety measures; along with abundant unknowns regarding the log-term outcomes of this intervention. Thus, this review offers an up-to-date perspective for the integration of FT into current clinical practice.