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Fecal microbiota transplantation: present and future
Ra Ri Cha, Irene Sonu
Clin Endosc 2025;58(3):352-359.   Published online March 25, 2025
DOI: https://doi.org/10.5946/ce.2024.270
AbstractAbstract PDFPubReaderePub
Fecal microbiota transplantation (FMT) involves transplanting fecal matter from healthy donors into patients with gut dysbiosis to restore microbial balance. It has been proven to be highly effective in treating recurrent Clostridioides difficile infection (CDI), and United States Food and Drug Administration-approved microbiome-based therapies, such as REBYOTA (fecal microbiota live-jslm) and VOWST (fecal microbiota spores live-brpk), offer promising treatment options. Although FMT is widely used to treat recurrent CDI, its use in gastrointestinal and metabolic diseases remains limited. Future research directions include optimizing donor selection, understanding microbial mechanisms, and exploring the potential of FMT for treating other diseases. Ongoing research not only aims to broaden its indications but also improves its safety and efficacy. Emerging therapies such as VE303 (Vedanta) are being studied to refine treatment approaches and expand the use of microbiota-based therapies. Further studies are needed to standardize guidelines, improve patient outcomes, and better define the role of FMT in the treatment of diseases beyond recurrent CDI.
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Alteration in gut microbiota after colonoscopy: proposed mechanisms and the role of probiotic interventions
Hyeong Ho Jo, Moon Young Lee, Se Eun Ha, Dong Han Yeom, Yong Sung Kim
Clin Endosc 2025;58(1):25-39.   Published online September 2, 2024
DOI: https://doi.org/10.5946/ce.2024.147
AbstractAbstract PDFPubReaderePub
Colonoscopy, a widely used procedure for diagnosing and treating colonic diseases, induces transient gastrointestinal symptoms and alterations in the gut microbiota. This review comprehensively examines the evidence on alterations in the gut microbiota following colonoscopy and their possible mechanisms. Factors such as rapid colonic evacuation, increased osmolality, and mucus thinning caused by bowel preparation and exposure to oxygen during the procedure contribute to these alterations. Typically, the alterations revert to the baseline within a short time. However, their long-term implications remain unclear, necessitating further investigation. Split-dose bowel preparation and CO2 insufflation during the procedure result in fewer alterations in the gut microbiota. Probiotic administration immediately after colonoscopy shows promise in reducing alterations and gastrointestinal symptoms. However, the widespread use of probiotics remains controversial due to the transient nature of both the symptoms and gut microbial alterations following a colonoscopy. Probiotics may offer greater benefits to individuals with preexisting gastrointestinal symptoms. Thus, probiotic administration may be a viable option for selected patients.

Citations

Citations to this article as recorded by  
  • Response to Ge and Chen
    Akira Higashimori, Natsumi Maeda, Yasuhiro Fujiwara
    American Journal of Gastroenterology.2025;[Epub]     CrossRef
  • Is It Advisable to Use Probiotics Routinely After a Colonoscopy? A Rapid Comprehensive Review of the Evidence
    Matteo Piciucchi, Alice Rossi, Alissa Satriano, Raffaele Manta
    Medical Sciences.2025; 13(2): 76.     CrossRef
  • Efficacy of Fecal Microbial Transplantation for Improving Symptoms of Irritable Bowel Syndrome - A Pilot Study for Voluntary Participants in Korea
    Jung Won Lee, Nayoung Kim
    The Korean Journal of Gastroenterology.2024; 84(4): 168.     CrossRef
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  • 816 Download
  • 1 Web of Science
  • 3 Crossref
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Case Report
Ischemic colitis complicated by Clostridioides difficile infection treated with fecal microbiota transplantation
Seok Hyung Kang, Tae-Geun Gweon, Hyunjung Hwang, Myong Ki Baeg
Clin Endosc 2023;56(5):666-670.   Published online January 20, 2022
DOI: https://doi.org/10.5946/ce.2021.199
AbstractAbstract PDFPubReaderePub
Ischemic colitis is an inflammatory condition of the colon that results from insufficient blood supply commonly caused by enterocolitis, vessel occlusion, or shock. In contrast, pseudomembranous colitis is a clinical manifestation of Clostridioides difficile infection (CDI). Ischemic colitis caused by CDI has rarely been reported. Fecal microbiota transplantation (FMT) is an efficient treatment for refractory or fulminant CDI, and the indications for its use have recently expanded. However, performing FMT in patients with ischemic colitis is challenging because of the risk of perforation. Here, we have presented a case of ischemic colitis caused by CDI that was successfully treated with FMT via sigmoidoscopy.

Citations

Citations to this article as recorded by  
  • Metronidazole/vancomycin

    Reactions Weekly.2025; 2049(1): 222.     CrossRef
  • Case of Pseudomembranous Colitis Caused by a Clostridioides difficile Infection Concomitant with Cytomegalovirus colitis Mimicking Ischemic Colitis
    Hyo Suk Kim, Hye Min Kim, Tae-Geun Gweon
    The Korean Journal of Gastroenterology.2023; 81(3): 133.     CrossRef
  • Fecal microbiota transplantation in non-communicable diseases: Recent advances and protocols
    Sevag Hamamah, Roxana Gheorghita, Andrei Lobiuc, Ioan-Ovidiu Sirbu, Mihai Covasa
    Frontiers in Medicine.2022;[Epub]     CrossRef
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  • 290 Download
  • 2 Web of Science
  • 3 Crossref
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Focused Review Series: Future Perspectiveses of Fecal Microbiota Transplatation
Fecal Microbiota Transplantation: Is It Safe?
Seon-Young Park, Geom Seog Seo
Clin Endosc 2021;54(2):157-160.   Published online March 30, 2021
DOI: https://doi.org/10.5946/ce.2021.072
AbstractAbstract PDFPubReaderePub
Fecal microbiota transplantation (FMT) is an accepted procedure for the management of recurrent Clostridioides difficile infections. FMT is generally considered safe and well-tolerated - even in high-risk patients. Most short-term risks are mild and known to be associated with delivery methods. Long-term side effects have not been established, and no signs of harm have been found to date. However, causality for several microbiome-associated diseases has to be established. Even though FMT is generally considered safe with strict donor screening, serious adverse events have been recently associated with the FMT product from the stool bank, where screening for multi-drug resistant organisms is not included in protocols. Here, we discuss the adverse events associated with FMT and safety issues.

Citations

Citations to this article as recorded by  
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    Journal of Clinical Investigation.2025;[Epub]     CrossRef
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    Henry Sutanto, Elisa Elisa, Betty Rachma, Deasy Fetarayani
    The American Journal of Medicine.2025; 138(5): 769.     CrossRef
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    Tomohiro Chaki, Yuri Horiguchi, Shunsuke Tachibana, Satoshi Sato, Tomoki Hirahata, Noriaki Nishihara, Natsumi Kii, Yusuke Yoshikawa, Kengo Hayamizu, Michiaki Yamakage
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  • A Novel Frontier in Gut–Brain Axis Research: The Transplantation of Fecal Microbiota in Neurodegenerative Disorders
    Majid Eslami, Zarifeh Adampour, Bahram Fadaee Dowlat, Shayan Yaghmayee, Faezeh Motallebi Tabaei, Valentyn Oksenych, Ramtin Naderian
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    Ra Ri Cha, Irene Sonu
    Clinical Endoscopy.2025; 58(3): 352.     CrossRef
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    Georgios Marinos, Inga K. Hamerich, Reena Debray, Nancy Obeng, Carola Petersen, Jan Taubenheim, Johannes Zimmermann, Dana Blackburn, Buck S. Samuel, Katja Dierking, Andre Franke, Matthias Laudes, Silvio Waschina, Hinrich Schulenburg, Christoph Kaleta, Pau
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    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Past, present, and future of microbiome-based therapies
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  • Changes in the Progression of Chronic Kidney Disease in Patients Undergoing Fecal Microbiota Transplantation
    Giovanna Yazmín Arteaga-Muller, Samantha Flores-Treviño, Paola Bocanegra-Ibarias, Diana Robles-Espino, Elvira Garza-González, Graciela Catalina Fabela-Valdez, Adrián Camacho-Ortiz
    Nutrients.2024; 16(8): 1109.     CrossRef
  • The Importance of Microbiota and Fecal Microbiota Transplantation in Pancreatic Disorders
    Adrian Boicean, Cristian Ichim, Samuel Bogdan Todor, Paula Anderco, Mirela Livia Popa
    Diagnostics.2024; 14(9): 861.     CrossRef
  • Can fecal microbiota transplantations modulate autoimmune responses in type 1 diabetes?
    Coco M. Fuhri Snethlage, Douwe de Wit, Koen Wortelboer, Elena Rampanelli, Nordin M. J. Hanssen, Max Nieuwdorp
    Immunological Reviews.2024; 325(1): 46.     CrossRef
  • Friend or Foe: Exploring the Relationship between the Gut Microbiota and the Pathogenesis and Treatment of Digestive Cancers
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    Ahran Lee, Jung Sik Yoo, Eun-Jeong Yoon
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  • Fecal Microbiota Transplantation: Insights into Colon Carcinogenesis and Immune Regulation
    Olga Brusnic, Danusia Onisor, Adrian Boicean, Adrian Hasegan, Cristian Ichim, Andreea Guzun, Radu Chicea, Samuel Bogdan Todor, Bogdan Ioan Vintila, Paula Anderco, Corina Porr, Horatiu Dura, Sorin Radu Fleaca, Adrian Nicolae Cristian
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  • Gut Microbiota and Immune System Dynamics in Parkinson’s and Alzheimer’s Diseases
    Natasa Kustrimovic, Sahar Balkhi, Giorgia Bilato, Lorenzo Mortara
    International Journal of Molecular Sciences.2024; 25(22): 12164.     CrossRef
  • Fecal microbiota transplantation for glaucoma; a potential emerging treatment strategy
    Rasoul Ebrahimi, Yeganeh Farsi, Seyed Aria Nejadghaderi
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  • Health Benefits of Prebiotics, Probiotics, Synbiotics, and Postbiotics
    Nasser Al-Habsi, Maha Al-Khalili, Syed Ariful Haque, Moussa Elias, Nada Al Olqi, Tasnim Al Uraimi
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    Marija Mihailovich, Maja Tolinački, Svetlana Soković Bajić, Sanja Lestarevic, Milica Pejovic-Milovancevic, Nataša Golić
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    Nathan D. Nuzum, Clara Deady, Sarah Kittel-Schneider, John F. Cryan, Siobhain M. O'Mahony, Gerard Clarke
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  • Metabolites in the Dance: Deciphering Gut-Microbiota-Mediated Metabolic Reprogramming of the Breast Tumor Microenvironment
    Afaf Altrawy, Maye M. Khalifa, Asmaa Abdelmaksoud, Yomna Khaled, Zeinab M. Saleh, Hager Sobhy, Shaimaa Abdel-Ghany, Amany Alqosaibi, Afnan Al-Muhanna, Jawaher Almulhim, Ahmed El-Hashash, Hussein Sabit, Borros Arneth
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    Xu Gu, Zhao-Hong Chen, Shu-Cheng Zhang
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    Nano Today.2023; 48: 101731.     CrossRef
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    Gudimetla Susmitha, Rahul Kumar
    Neuropharmacology.2023; 229: 109478.     CrossRef
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    Antibiotics.2023; 12(3): 435.     CrossRef
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    Walaa K. Mousa, Rose Ghemrawi, Tareq Abu-Izneid, Azza Ramadan, Farah Al-Marzooq
    International Journal of Molecular Sciences.2023; 24(8): 6901.     CrossRef
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    Raghad Khalid AL-Ishaq, Samson Mathews Samuel, Dietrich Büsselberg
    International Journal of Molecular Sciences.2023; 24(9): 8118.     CrossRef
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    Brian Bicknell, Ann Liebert, Thomas Borody, Geoffrey Herkes, Craig McLachlan, Hosen Kiat
    International Journal of Molecular Sciences.2023; 24(11): 9577.     CrossRef
  • Gut Microbiome Transplants and Their Health Impacts across Species
    Benjamin H. Levine, Jessica M. Hoffman
    Microorganisms.2023; 11(6): 1488.     CrossRef
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    Anne J. Gonzales-Luna, Travis J. Carlson, Kevin W. Garey
    Gut Microbes.2023;[Epub]     CrossRef
  • The Role of Gut Dysbiosis in the Loss of Intestinal Immune Cell Functions and Viral Pathogenesis
    Farzaneh Fakharian, Siva Thirugnanam, David A. Welsh, Woong-Ki Kim, Jay Rappaport, Kyle Bittinger, Namita Rout
    Microorganisms.2023; 11(7): 1849.     CrossRef
  • Swiss expert opinion: current approaches in faecal microbiota transplantation in daily practice
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    Swiss Medical Weekly.2023; 153(8): 40100.     CrossRef
  • Non-alcoholic fatty liver disease and gut microbial dysbiosis- underlying mechanisms and gut microbiota mediated treatment strategies
    Muthukumaran Jayachandran, Shen Qu
    Reviews in Endocrine and Metabolic Disorders.2023; 24(6): 1189.     CrossRef
  • Fecal Microbiota Transplantation in Liver Cirrhosis
    Adrian Boicean, Victoria Birlutiu, Cristian Ichim, Olga Brusnic, Danusia Maria Onișor
    Biomedicines.2023; 11(11): 2930.     CrossRef
  • Fecal Microbiota Transplantation in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Parnian Jamshidi, Yeganeh Farsi, Zahra Nariman, Mohammad Reza Hatamnejad, Benyamin Mohammadzadeh, Hossein Akbarialiabad, Mohammad Javad Nasiri, Leonardo A. Sechi
    International Journal of Molecular Sciences.2023; 24(19): 14562.     CrossRef
  • Gut microbiota of Suncus murinus, a naturally obesity-resistant animal, improves the ecological diversity of the gut microbiota in high-fat-diet-induced obese mice
    Mingshou Zhang, Ting Yang, Rujia Li, Ke Ren, Jun Li, Maozhang He, Juefei Chen, Shuang-Qin Yi, Farah Al-Marzooq
    PLOS ONE.2023; 18(11): e0293213.     CrossRef
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    Xiaoxiao Pang, Long Chen, Guoxin Xu
    Polish Journal of Microbiology.2023; 72(4): 355.     CrossRef
  • Clinical Practice Guidelines for Fecal Microbiota Transplantation in Korea
    Tae-Geun Gweon, Yoo Jin Lee, Kyeong Ok Kim, Sung Kyun Yim, Jae Seung Soh, Seung Young Kim, Jae Jun Park, Seung Yong Shin, Tae Hee Lee, Chang Hwan Choi, Young-Seok Cho, Dongeun Yong, Jin-Won Chung, Kwang Jae Lee, Oh Young Lee, Myung-Gyu Choi, Miyoung Choi
    Journal of Neurogastroenterology and Motility.2022; 28(1): 28.     CrossRef
  • A Potential Synbiotic Strategy for the Prevention of Type 2 Diabetes: Lactobacillus paracasei JY062 and Exopolysaccharide Isolated from Lactobacillus plantarum JY039
    Jiayuan Zhao, Lihan Wang, Shasha Cheng, Yu Zhang, Mo Yang, Ruxue Fang, Hongxuan Li, Chaoxin Man, Yujun Jiang
    Nutrients.2022; 14(2): 377.     CrossRef
  • Linking circadian rhythms to microbiome-gut-brain axis in aging-associated neurodegenerative diseases
    Wai-Yin Cheng, Yuen-Shan Ho, Raymond Chuen-Chung Chang
    Ageing Research Reviews.2022; 78: 101620.     CrossRef
  • Modulating the Gut Microbiota as a Therapeutic Intervention for Alzheimer’s Disease
    Mingli Liu, Ping Zhong
    Indian Journal of Microbiology.2022; 62(4): 494.     CrossRef
  • Role of Microbiota in Viral Infections and Pathological Progression
    Taketoshi Mizutani, Aya Ishizaka, Michiko Koga, Takeya Tsutsumi, Hiroshi Yotsuyanagi
    Viruses.2022; 14(5): 950.     CrossRef
  • Current Trends and Challenges of Fecal Microbiota Transplantation—An Easy Method That Works for All?
    Cátia Almeida, Rita Oliveira, Pilar Baylina, Rúben Fernandes, Fábio G. Teixeira, Pedro Barata
    Biomedicines.2022; 10(11): 2742.     CrossRef
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Fecal Microbiota Transplantation beyond Clostridioides Difficile Infection
Chang Mo Moon, Sung Noh Hong
Clin Endosc 2021;54(2):149-151.   Published online March 26, 2021
DOI: https://doi.org/10.5946/ce.2021.068
AbstractAbstract PDFPubReaderePub
With advancing analytical methods for gut microbes, many studies have been conducted, revealing that gut microbes cause various diseases, including gastrointestinal and non-gastrointestinal diseases. Accordingly, studies have been actively conducted to analyze the effects on the prevention and treatment of these diseases through changes in intestinal microbes and control of dysbiosis. Fecal microbiota transplantation (FMT) is an effort and is currently being applied to Clostridioides difficile treatment in Korea. Many studies have demonstrated the application of FMT in inflammatory bowel disease, irritable bowel syndrome, non-alcoholic fatty liver disease, metabolic syndrome, obesity, and diabetes. With further studies and accumulation of evidence, FMT could help treat presently untreatable diseases in clinical practice.
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Next Generation Fecal Microbiota Transplantation
Tae-Geun Gweon, Soo-Young Na
Clin Endosc 2021;54(2):152-156.   Published online March 24, 2021
DOI: https://doi.org/10.5946/ce.2021.053
AbstractAbstract PDFPubReaderePub
Fecal microbiota transplantation (FMT) is considered as an effective treatment for Clostridioides difficile infection. However, the precise mechanism of FMT is yet to be determined. Human stool consists of the gut microbiota, bacterial debris, and metabolic products. Of these, the intestinal microbiota is the most important factor that exerts therapeutic efficacy in FMT. Fresh donor stool, blended with normal saline, has been employed for traditional FMT. Nevertheless, stool processing is a major impediment in FMT. Frozen stool and capsule formulations have similar efficacy to that of fresh stool. In addition, several novel stool products have been identified. A stool bank that provides stool products with pre-screened donor stool has been established to help physicians and thereby facilitate FMT. Recent next-generation sequencing techniques have been key in facilitating the detailed analysis of the microbiota and gut environment of individual donors and recipients.

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Reviews
Fecal Microbiota Transplantation: An Update on Clinical Practice
Kyeong Ok Kim, Michael Gluck
Clin Endosc 2019;52(2):137-143.   Published online March 26, 2019
DOI: https://doi.org/10.5946/ce.2019.009
AbstractAbstract PDFPubReaderePub
Fecal microbiota transplantation (FMT) is an infusion in the colon, or the delivery through the upper gastrointestinal tract, of stool from a healthy donor to a recipient with a disease believed to be related to an unhealthy gut microbiome. FMT has been successfully used to treat recurrent Clostridium difficile infection (rCDI). The short-term success of FMT in rCDI has led to investigations of its application to other gastrointestinal disorders and extra-intestinal diseases with presumed gut dysbiosis. Despite the promising results of FMT in these conditions, several barriers remain, including determining the characteristics of a healthy microbiome, ensuring the safety of the recipient with respect to long-term outcomes, adequate monitoring of the recipient of fecal material, achieving high-quality control, and maintaining reasonable costs. For these reasons, establishing uniform protocols for stool preparation, finding the best modes of FMT administration, maintaining large databases of donors and recipients, and assuring that oral ingestion is equivalent to the more widely accepted colonoscopic infusion are issues that need to be addressed.

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Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives
Hyun Ho Choi, Young-Seok Cho
Clin Endosc 2016;49(3):257-265.   Published online March 9, 2016
DOI: https://doi.org/10.5946/ce.2015.117
AbstractAbstract PDFPubReaderePub
Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.

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  • Parkinson’s Disease: The Emerging Role of Gut Dysbiosis, Antibiotics, Probiotics, and Fecal Microbiota Transplantation
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  • The Microbiota and Cancer Cachexia
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  • Enteric Microbiome Markers as Early Predictors of Clinical Outcome in Allogeneic Hematopoietic Stem Cell Transplant: Results of a Prospective Study in Adult Patients
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