title: Review article: faecal transplantation therapy for gastrointestinal disease.
abstract: BACKGROUND
  Evidence is emerging regarding the relationship between a dysbiosis of the human gut microbiota and a number of gastrointestinal diseases as well as diseases beyond the gut. Probiotics have been investigated in many gastrointestinal disease states, with variable and often modest outcomes. Faecal transplantation is an alternative approach to manipulate the gut microbiota.
  
  
  OBJECTIVE
  To review the use of faecal transplantation therapy for the management of gastrointestinal disorders.
  
  
  METHODS
  Available articles on faecal transplantation in the management of gastrointestinal disorders were identified using a Pubmed search and bibliographies of review articles on the subject were collated.
  
  
  RESULTS
  A total of 239 patients who had undergone faecal transplantation were reported. Seventeen of 22 studies of faecal transplantation were in fulminant or refractory Clostridium difficile. Studies of faecal transplantation are heterogeneous regarding the patients, donors, screening, methods of administration and definition of response. Faecal transplantation for C. difficile has been demonstrated to be effective in 145/166 (87%) patients. Small numbers of patients are reported to have undergone successful faecal transplantation for irritable bowel syndrome and inflammatory bowel disease.
  
  
  CONCLUSIONS
  Faecal transplantation has been reported with good outcomes for fulminant and refractory C. difficile. No adverse effects of faecal transplantation have been reported. However, there are no level 1 data of faecal transplantation and reports to date may suffer from reporting bias of positive outcomes and under-reporting of adverse effects. This therapy holds great promise, where a dysbiosis of the gut microbiota is responsible for disease and further studies are necessary to explore this potential.
authors.affiliation: IBD Unit, St Mark's Hospital, Harrow, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Landy
authors.forename: H O
authors.initials: HO
authors.lastname: Al-Hassi
authors.forename: S D
authors.initials: SD
authors.lastname: McLaughlin
authors.forename: A W
authors.initials: AW
authors.lastname: Walker
authors.forename: P J
authors.initials: PJ
authors.lastname: Ciclitira
authors.forename: R J
authors.initials: RJ
authors.lastname: Nicholls
authors.forename: S K
authors.initials: SK
authors.lastname: Clark
authors.forename: A L
authors.initials: AL
authors.lastname: Hart
mesh_terms: D018407:Bacterial Physiological Phenomena; D005243:Feces / Q000382:microbiology*; D005767:Gastrointestinal Diseases / Q000628:therapy*; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D056265:Microbial Interactions