Worldwide prevalence of Ulcerative Colitis has been on the rise since the 1990’s. It’s specifically on the rise in newly-industrialized countries adopting western medical practices and diets. Currently there is no cure for Ulcerative Colitis, but there is hope in the form of a treatment known as FMT.
Fecal Microbiota Transplants (FMT) are, simply put, poop transplants. We will cover more about what they are and how they can be used to treat Ulcerative Colitis in the following sections of this article:
- What is Ulcerative Colitis and what causes it?
- The connection between the microbiome and Ulcerative Colitis
- Are fecal transplants an Ulcerative Colitis cure?
- Ulcerative Colitis fecal transplant studies and trials
- Where can I get an FMT for UC?
- More information on Ulcerative Colitis and FMT
What is Ulcerative Colitis and what causes it?
Ulcerative Colitis (UC) is a chronic inflammatory disease of the colon, including the rectum and anus. It usually begins from the rectum and extends upwards through the colon. UC is a lifelong disease that can develop at any age, though there are peaks in reported cases from ages 15-30, and 50-70.
What are the causes of Ulcerative Colitis?
Like many chronic diseases, the exact Ulcerative Colitis causes are unknown. UC is thought to be an overreaction of the immune system, and the result of a combination of factors including hereditary traits, immune system issues, and environmental factors (such as exposure to bacteria or a virus).
When the immune system is triggered, the result is inflammation of the colon. This continuous inflammation is what creates Ulcerative Colitis symptoms. Some people appear to be at greater risk of developing Ulcerative Colitis, including those with Jewish-European ancestry. Men and women seem to be affected equally.
What are the symptoms of Ulcerative Colitis?
- Abdominal pain
- Blood or mucus in stool
- Frequent, recurring diarrhea
- Reduced appetite
- Weight loss
- Sudden and constant feelings of needing to use the toilet
Along with the basic symptoms there are also serious complications associated with colitis, including:
- Profuse bleeding
- Rupture of the bowel
- Severe symptoms that do not respond to medication
- Increased risk of colon cancer, due to chronic inflammation
- Vitamin deficiencies
If the disease progresses to this level, your doctor may suggest surgery to remove or repair the affected sections of your large intestine.
Common UC treatment and surgery options
Ulcerative Colitis treatment depends on the severity of each case. Cases are generally managed with different medications and some people find diets and natural remedies for Ulcerative Colitis effective. Though diets and medication can help manage UC, many people will continue to have bad or worsening symptoms.
For those who continue to have severe symptoms despite the use of medication, surgery is an option. Partial or full removal of the colon is possible (known as a colectomy). In a colectomy, the colon (or part of it) is removed and replaced by a medical bag that acts as a transplant colon. The bag is left outside the body at first, but may be put inside at a later time if the patient recovers well.
These common treatments for UC are unsatisfactory for many, as is allowing your illness to progress to the point of needing a colectomy. Thankfully, alternative new treatments for UC are being explored, and one of the more promising ones include FMT. The possibility of FMT and continued focus on treating the microbiome could one day mean the end of the invasive surgeries that are currently common practice for treating Ulcerative Colitis.
The connection between the microbiome and Ulcerative Colitis
The microbiome, and specifically the gut microbiome, has a connection to the symptoms of Ulcerative Colitis. Firstly, those with UC tend to have a significantly different microbial make up than those who do not have Colitis. To boot, affecting the microbiome seems to also affect the symptoms of UC.
The microbiome’s role in the body
The microbiome is all the bacteria, fungi, protozoa and viruses that live in our bodies. It impacts the health of our immune system, GI system, and even our brain. There are different microbiome communities that live in our noses, ears, eyes, guts and on our skins.
The microbiome is thought to be a factor in the symptoms associated with Ulcerative Colitis, but how does that connection specifically function?
The microbiome’s role in Ulcerative Colitis
There are several studies linking Ulcerative Colitis to an imbalance within the gut microbiome. Researchers have been able to show on multiple occasions that there are significant differences in the microbial composition in the guts of those with and without Ulcerative Colitis.
The connection between microbiome dysbiosis and Ulcerative Colitis inflammation is an early sign that FMT has potential to treat UC. Studies have already showed the ability of fecal transplants to reduce inflammation in those with UC and more studies are underway to back up the preliminary results.
Are fecal transplants an Ulcerative Colitis cure?
Fecal transplants are becoming an accepted cure for Ulcerative Colitis. FMT has demonstrated effectiveness in successfully leading many UC patients into remission. Fecal transplants for UC is promising for those who have difficulty managing and keeping their flare-ups of Colitis at bay.
What are fecal transplants?
Fecal microbiota transplants, or FMT, are performed by taking poop from a healthy donor and implanting it into the gut of a sick patient. FMT works by engrafting the gut with good bacteria from a donor in the hope that the good will outperform the bad, and restore balance to the gut microbiome.
How does FMT treat Ulcerative Colitis
Significant microbial differences have been noted in the guts of those who suffer from Ulcerative Colitis. Researchers believe that microbiome dysbiosis may play a large part in the symptoms of UC. FMT can be used to treat that dysbiosis, and by proxy, treat the symptoms of Colitis.
“Dysbiosis” is the scientific way of explaining microbiome imbalance. It describes when the number of bad and harmful bacteria in the gut outnumber and outperform the good bacteria. It seems that FMT is a convenient solution to treat UC, but has enough research been done to support these ideas?
Ulcerative Colitis fecal transplant studies and trials
This 2010 study out of the Institute of Food Research in the UK is one that has enabled further research into the effects of microbiome altering practices such as FMT. The study showed that the abnormalities of intestinal microbiota in Ulcerative Colitis patients were common.
Who Worked on It: Now the Quadram Institute, formerly the Institute of Food Research, in Norwich, UK.
Date Published: November 2010
Highlights of Results: A significant decrease in bacterial species was noted in those with Ulcerative Colitis over those without the condition. The genetic sequencing of samples also suggested that Bacteroides vulgatus, B. ovatus, B. uniformis, and Parabacteroides sp. are largely present in healthy individuals and not in individuals with UC.
What’s Next: Research associating the microbiome and Ulcerative Colitis has allowed research on the possible effects of FMT on UC to be legitimized and move forward.
The McMaster trials and the amazing donor B
This landmark study out of McMaster University was the first randomized, placebo-controlled study on the effectiveness of FMT as an Ulcerative Colitis natural treatment. The study found that FMT leads to remission in a significant number of cases treated by the therapy.
Who Worked on It: Research team at McMaster University in Hamilton, Ontario led by Dr Paul Moayyedi.
Date Published: July 2015
Highlights of Results: The study resulted in 26% of patients treated with FMT entering remission. The number was even great for one donor in particular. The donor known in the study as “donor B” induced remission in 39% of the subjects who used their stool, while donor A resulted in zero cases of remission.
What’s Next: Larger and more specific studies need to be performed to reach conclusive answers about the potential to treat Ulcerative Colitis with FMT. Further exploration of the specific bacteria present in donors like donor B is key to understanding what makes their stool so effective in treating UC.
3. The Australian trials – the biggest study to date
This study out of the St Vincent’s Hospital and the University of New South Wales was the biggest study on FMT for Ulcerative Colitis to date. It used FMTs composed of stool from three to seven donors, in an attempt to increase microbiome diversity in the sample. Results showed higher percentage of success than the previous McMaster study.
Who Worked on It: St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia
Date Published: February 2017
Highlights of Results: Of the 85 patients enrolled in the study, 42 received FMT therapy, and of those 42, 44% achieved remission and 54% achieved at least some positive clinical response. The higher overall percentage of remission achieved in this study might very well be associated with the increased microbiota diversity in the samples given to the subjects.
What’s Next: Continued study of the Ulcerative Colitis reaction to FMT treatments, while focusing on the exact microbiota that is most successful in treating UC and allowing patients to achieve remission.
Where can I get an FMT for UC?
FMT is not yet widely available for the treatment of Ulcerative Colitis. So far, much of the FMT treatments for UC are still in the trial period. Studies are still at too early of a stage to determine exactly how successful the treatment is compared to other existing and trusted treatment methods.
If you are considering performing a DIY at home fecal transplant for Ulcerative Colitis, we recommend first reaching out to clinics or trials in your area performing the treatment. Without the proper clinical setting, and proper testing of the stool sample you’re using, the safety of the procedure simply can’t be guaranteed.
Though studies are still underway, there are some clinics and doctors that will perform the procedure. If you are interested in finding out if there is someone near you, you can check out our list of FMT clinics and doctors.
More information on Ulcerative Colitis and FMT
These articles can help teach you more about how FMT is being used as a treatment, and how it is helping with Ulcerative Colitis.
Learn more about all of the resources available to help you learn more about fecal transplants, including current clinical studies, the best doctors, where to get FMT news, and more.
A helpful list outlining what you she be asking your doctor to get the best care for your Ulcerative Colitis. Get answers to often overlooked or forgotten questions hat you should know.
Learn about how fecal transplants are being used to treat a whole host of conditions from Crohn’s to Autism. Find out what the latest studies are saying and what the future holds for FMT.
Learn more about the results of the largest FMT Ulcerative Colitis study to date, in this easy to follow summary. Written by a fellow Ulcerative Colitis sufferer.
FMT is an incredibly safe and effective treatment for the all-too-common Clostridium Difficile infection. Learn more about how fecal transplants work for C Diff, and where they are being done.