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Faecal microbiota transplantation as a treatment for inflammatory bowel disease: a national survey of adult and paediatric gastroenterologists in the UK
  1. James Roger Mcilroy1,2,
  2. Niharika Nalagatla1,
  3. Richard Hansen3,
  4. Ailsa Hart4,
  5. Georgina Louise Hold1,5
  1. 1School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
  2. 2EnteroBiotix Limited, Aberdeen, UK
  3. 3Royal Hospital for Children, Glasgow, UK
  4. 4IBD Unit, St Mark’s Hospital, Harrow, UK
  5. 5Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to James Roger Mcilroy, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, Scotland; james.mcilroy.11{at}aberdeen.ac.uk and Prof Georgina Louise Hold; georgina.hold{at}unsw.edu.au

Abstract

Background Interest in the use of faecal microbiota transplantation (FMT) in inflammatory bowel disease (IBD) has increased following outcomes in patients with Clostridioides difficile infection (CDI). While research exploring clinician awareness and attitude towards the use of FMT in CDI has been carried out, data for IBD are currently lacking.

Objective To assess the perceptions of gastroenterologists and current practice relating to FMT as a treatment for IBD in the UK.

Design A web-based survey (Snap Survey software) was distributed through the British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition e-newsletters, and at the BSG Conference in June 2017.

Results 61 respondents completed the survey including presubspecialty trainees, gastroenterology specialists, associate specialists and consultants. Most (95%; n=58) respondents stated that they had heard of FMT being used as a treatment for IBD prior to participating in the survey. Based on current evidence, 34% (n=21) of respondents would consider using FMT in patients with IBD, 26% (n=16) would not and 39% (n=24) were undecided. When asked to rank routes of delivery in terms of preference, nasogastric tube was the least preferred route (39%; n=24) and oral capsule was the most preferred route (34%; n=21).

Conclusions A clear majority of UK gastroenterologists recognise FMT as a potential treatment for IBD; however, uptake is limited. A proportion of clinicians would consider FMT in IBD and the majority would consider entering patients into clinical trials. Future work should explore the utility and efficacy of oral FMT capsules in IBD.

  • ulcerative colitis
  • IBD
  • crohn’s disease

https://doi.org/10.1136/flgastro-2017-100936

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    Footnotes

    • JM and NN are joint first authors.

    • Contributors GLH is the guarantor of the article. JRM, NN, AH, RH and GLH reviewed the literature and developed the survey. JRM and NN prepared the manuscript. All authors have revised the manuscript critically and prepared its final version. All authors approved the final draft prior to submission.

    • Funding RH is funded by a Career Researcher Fellowship from NHS Research Scotland. The Glasgow Paediatric IBD team is supported by the Catherine McEwan Foundation.

    • Competing interests JRM has received salary, consultancy fees and other from EnteroBiotix Limited and Biotechspert Limited during the conduct of the study. RH has received speaker’s fees, consultancy fees or travel support from Nutricia, MSD Immunology, Dr Falk and 4D Pharma. GLH has received consultancy fees or travel support from Nutricia and 4D Pharma. AH has served as consultant, advisory board member or speaker for AbbVie, Atlantic, Bristol-Myers Squibb, Celltrion, Falk, Ferring, Janssen, MSD, Napp Pharmaceuticals, Pfizer, Pharmacosmos, Shire and Takeda. She also serves on the Global Steering Committee for Genentech. NN has nothing to disclose.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Correction notice This article has been corrected since it published Online First. The joint author statement has been added.

    • Presented at The abstract was displayed in poster format at the 13th Congress of The European Crohn’s and Colitis Organisation (ECCO) in Vienna, February 2018.