Système gastro-intestinal et digestif

Abstrait

The Efficacy of Self-administered Home Fecal Transplant in Inducing and Maintaining Remission in Crohn's Pancolitis with Perianal Fistulae

Anas Almoghrabi, Estefania Flores, Obaie Mzaik, Chimezie Mbachi, Bashar Attar and Melchor Demetria

A substantial proportion of patients with Crohn’s Disease (CD) do not respond to the currently available medications with potential long-term consequences. Consequently, alternative safer therapies are being studied, such as Fecal Microbiota Transplantation (FMT). The Food and Drug Administration (FDA) approved the use of FMT for recurrent Clostridium difficile (C. diff) but has tighter restrictions for Inflammatory Bowel Disease (IBD). Those patients can only get a fecal transplant in a medical setting if they are participating in a clinical trial. A handful of case reports have shown the effectiveness of self-administered home fecal transplant in recurrent C. difficile, and the efficacy of FMT, under monitored environment, in refractory CD unresponsive to current conventional therapy. However, no reported cases showing the efficacy of self-administered home fecal transplant in patients with fistulizing CD. This is the first case report showing the efficacy of self-administered home fecal transplant as a single agent in the management of Crohn’s pancolitis with perianal fistulae.