Gastrointestine

FMT involves instillation of stools obtained from a healthy donor into the recipient gut either by upper gastrointestinal (GI) route through naso-gastric tube or through lower GI route administered during colonoscopy or rectal enemas. There are no controlled studies comparing the efficacy and safety of upper and lower GI routes of FMT delivery in the treatment of CDI. In the absence of such studies, the preferable method of FMT administration is unknown. Earlier in 2012, we published a pooled-data analysis of studies on FMT in the treatment of CDI (289 patients). In this analysis, we showed that the rate of treatment failure was 15.4% with upper GI route compared to 6.6% with lower GI route of FMT delivery. This difference in the treatment outcome between the two routes of FMT delivery was statistically significant in univariate analysis (p=0.027), however no significance was noted in multivariate analysis (p=0.569). Similar results were later obtained from a meta-analysis by Kassam et al. with an observed trend towards higher clinical resolution rates by lower GI route compared to upper GI route of delivery of FMT. Although, pooled-data analysis by Postigo and Kim did not show any difference in the treatment efficacy by upper or lower GI routes of FMT delivery, the number of cases analyzed in this analysis was smaller (182 patients) compared to former two reviews.

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Last date updated on April, 2024