The American Gastroenterological Association (AGA) has issued the first evidence-based guideline on the use of fecal microbiota-based therapies for gastrointestinal disease, recommending fecal microbiota transplant (FMT) for most patients with recurrent Clostridioides difficile (C. diff) infection. FMT involves transferring stool from a healthy donor to the colon of the patient with recurrent C. diff, restoring balance to their gut microbiome. The AGA states that FMT is a safe and effective treatment with sufficient scientific evidence to be offered to most patients with two or more C. diff recurrences.
C. diff infection affects nearly half a million people in the U.S. each year, and approximately one in six of those people experience a recurrence within two to eight weeks. The AGA guideline recommends FMT for patients with recurrent C. diff infection at a high risk of recurrence, and for hospitalized patients with severe C. diff infection. However, FMT therapies are not recommended for inflammatory bowel diseases (IBD) or irritable bowel syndrome (IBS), and the AGA encourages patients interested in FMT for conditions other than C. diff to participate in a clinical trial.
The AGA emphasizes that FMT offers hope to patients suffering from recurrent C. diff infection, providing a safe and effective treatment option. The majority of patients with recurrent C. diff are considered candidates for FMT to prevent recurrence. Amanda Kabage, an FMT researcher and recipient, expressed gratitude for the guideline, stating that it will reduce the suffering of patients and enable them to lead healthier lives. The guideline covers conventional FMT, as well as newly FDA-approved therapies such as fecal microbiota delivered via enema and oral capsules.
