title: Fecal microbiota transplantation: indications, methods, evidence, and future directions.
abstract: Fecal microbiota transplantation (FMT) has attracted great interest in recent years, largely due to the global Clostridium difficile infection (CDI) epidemic and major advances in metagenomic sequencing of the gastrointestinal (GI) microbiota, with growing understanding of its structure and function. FMT is now recommended as the most effective therapy for relapsing CDI and, with further refinement, may even be used in "first-time" CDI. There is interest also in other conditions related to GI dysbiosis--for example, inflammatory bowel disease, irritable bowel syndrome, obesity, and diabetes mellitus--although quality evidence is at present lacking. A few trials are now underway in FMT for ulcerative colitis. Many unanswered questions remain, including FMT methodology--for example, optimal route of administration, what makes a "good donor," safety issues, and long-term effects of FMT.
authors.affiliation: Centre for Digestive Diseases, Level 1, 229 Great North Road, Five Dock, Sydney, NSW 2046, Australia. thomas.borody@cdd.com.au
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Borody
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Paramsothy
authors.forename: Gaurav
authors.initials: G
authors.lastname: Agrawal
mesh_terms: D001691:Biological Therapy / Q000379:methods* / Q000639:trends; D004761:Enterocolitis, Pseudomembranous / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000379:methods; D005243:Feces / Q000382:microbiology*; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D043183:Irritable Bowel Syndrome / Q000628:therapy; D064307:Microbiota