Clinical remission of ulcerative colitis after different modes of faecal microbiota transplantation: a meta-analysis

Background Ulcerative colitis (UC) is a chronic, recurrent and destructive disease of the gastrointestinal tract. Faecal microbiota transplantation (FMT) is a therapeutic measure in which faecal microbiota from healthy people is transplanted into patients. Aim To systematically evaluate the safety and effectiveness of treating UC with different modes of FMT. Methods Seven databases were searched by two independent researchers and studies related to randomized controlled trials were included in the analysis. Results Seven studies on UC involving 431 patients were included in the analysis. The results showed that FMT had better efficacy than placebo (OR = 2.29, 95% CI 1.48–3.53, P = 0.0002). Subgroup analyses of influencing factors showed that frozen faeces from multiple donors delivered via the lower gastrointestinal tract had a better curative effect than placebo (OR = 2.76, 95% CI 1.59–4.79, P = 0.0003; OR = 2.93, 95% CI 1.67–5.71, P = 0.0002; and OR = 2.70, 95% CI 1.67–4.37, P < 0.0001); the difference in efficacy between mixed faeces from a single donor transplanted through the upper gastrointestinal tract and placebo was not significant( P = 0.05, P = 0.09 and P = 0.98). The analysis of side effects showed no significant difference between FMT and placebo ( P = 0.43). Conclusions It may be safe and effective to transplant frozen faeces from multiple donors through the lower gastrointestinal tract to treat UC.