title: Fecal microbiota transplantation as novel therapy in gastroenterology: A systematic review.
abstract: OBJECTIVE
  To study the clinical efficacy and safety of Fecal microbiota transplantation (FMT). We systematically reviewed FMT used as clinical therapy.
  
  
  METHODS
  We searched MEDLINE, EMBASE, the Cochrane Library and Conference proceedings from inception to July, 2013. Treatment effect of FMT was calculated as the percentage of patients who achieved clinical improvement per patient category, on an intention-to-treat basis.
  
  
  RESULTS
  We included 45 studies; 34 on Clostridium difficile-infection (CDI), 7 on inflammatory bowel disease, 1 on metabolic syndrome, 1 on constipation, 1 on pouchitis and 1 on irritable bowel syndrome (IBS). In CDI 90% resolution of diarrhea in 33 case series (n = 867) was reported, and 94% resolution of diarrhea after repeated FMT in a randomized controlled trial (RCT) (n = 16). In ulcerative colitis (UC) remission rates of 0% to 68% were found (n = 106). In Crohn's disease (CD) (n = 6), no benefit was observed. In IBS, 70% improvement of symptoms was found (n = 13). 100% Reversal of symptoms was observed in constipation (n = 3). In pouchitis, none of the patients (n = 8) achieved remission. One RCT showed significant improvement of insulin sensitivity in metabolic syndrome (n = 10). Serious adverse events were rare.
  
  
  CONCLUSIONS
  FMT is highly effective in CDI, and holds promise in UC. As for CD, chronic constipation, pouchitis and IBS data are too limited to draw conclusions. FMT increases insulin sensitivity in metabolic syndrome.
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Noortje G
authors.initials: NG
authors.lastname: Rossen
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: John K
authors.initials: JK
authors.lastname: MacDonald
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: de Vries
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Geert R
authors.initials: GR
authors.lastname: D'Haens
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Willem M
authors.initials: WM
authors.lastname: de Vos
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Erwin G
authors.initials: EG
authors.lastname: Zoetendal
authors.affiliation: Noortje G Rossen, Elisabeth M de Vries, Geert R D'Haens, Cyriel Y Ponsioen, Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Cyriel Y
authors.initials: CY
authors.lastname: Ponsioen
mesh_terms: D016009:Chi-Square Distribution; D000069467:Fecal Microbiota Transplantation / Q000009:adverse effects; D005243:Feces / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D064307:Microbiota; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Clostridium difficile infection; Fecal microbiota transplantation; Inflammatory bowel disease; Metabolic syndrome; Microbiota