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Review
. 2025 Jun;54(2):277-293.
doi: 10.1016/j.gtc.2024.12.002. Epub 2025 Jan 24.

Optimizing Therapeutic Potential of Fecal Transplant in Inflammatory Bowel Disease

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Review

Optimizing Therapeutic Potential of Fecal Transplant in Inflammatory Bowel Disease

Samantha J Magier et al. Gastroenterol Clin North Am. 2025 Jun.

Abstract

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract influenced by genetic, environmental, immune, and microbial factors. Reduced gut microbial diversity and elevated proinflammatory bacteria levels in IBD disrupt mucosal immunity, barrier function, and inflammatory pathways. Fecal microbiota transplantation (FMT) is a potential therapy to restore microbial balance. Studies suggest that FMT may induce remission in mild-to-moderate ulcerative colitis but show limited efficacy in Crohn's disease and pouchitis. Donor microbiota colonization correlates with remission, but varied study designs challenge findings. Further research is required to standardize FMT protocols, optimize donor selection, and ensure long-term safety.

Keywords: Crohn’s disease; Fecal microbiota transplant; Gut microbial therapies; Gut microbiome; Randomized controlled trial; Ulcerative colitis.

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Conflict of interest statement

Disclosure S.J. Magier reports no potential conflicts of interest. T.S. Morley reports no potential conflicts of interest. C.R. Kelly has served on a scientific advisory board for Eli Lilly.

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