Patients' views on fecal microbiota transplantation: an acceptable therapeutic option in inflammatory bowel disease?

Eur J Gastroenterol Hepatol. 2017 Mar;29(3):322-330. doi: 10.1097/MEG.0000000000000783.

Abstract

Background: Fecal microbiota transplantation (FMT) represents a new therapeutic option that has been studied in two randomized-controlled trials in ulcerative colitis patients. Our study aimed to identify patients' views on the use of this novel therapeutic approach.

Methods: Using an anonymous questionnaire, we obtained data from 574 inflammatory bowel disease (IBD) patients on their knowledge and willingness to undergo FMT.

Results: A large proportion of IBD patients (53.5%) are unaware that FMT is a therapeutic option in Clostridium difficile infection and potentially IBD. More responders preferred FMT (31.5%) to a study with a new medication (28.9%), although the difference was not significant (P=0.37), and the preferred way of transplantation was colonoscopy (49.7%). In all, 38.3% preferred a family member as a donor, but there was fear about the procedure (41.5% mentioned fear of infectious diseases, 26.5% expressed disgust). The knowledge of successful FMT treatment in other patients was important for 82.2% of responders and for 50.7%, a discussion with a specialist would likely change their opinion about FMT.

Conclusion: FMT represents a therapeutic procedure that is of interest for IBD patients. As FMT has been receiving increasing interest as an alternative treatment in IBD and more studies on FMT in IBD are being carried out, it is important to learn about the knowledge, attitude, and preferences of patients to provide better education to patients on this topic. However, there are reservations because of the fact that data on the benefits of FMT in IBD are controversial and several limitations exist on the use of FMT in IBD.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Choice Behavior
  • Colitis, Ulcerative / microbiology
  • Colitis, Ulcerative / psychology
  • Colitis, Ulcerative / therapy*
  • Colonoscopy / psychology
  • Crohn Disease / microbiology
  • Crohn Disease / psychology
  • Crohn Disease / therapy*
  • Fear / psychology
  • Fecal Microbiota Transplantation / adverse effects
  • Fecal Microbiota Transplantation / methods
  • Fecal Microbiota Transplantation / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Patient Preference
  • Risk Factors
  • Surveys and Questionnaires
  • Tissue Donors / supply & distribution
  • Young Adult