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Concerning Fecal Microbiota Transplantation (FMT) & Ulcerative Colitis (UC), the premise of Fecal Microbiota Transplantation (FMT) is to restore the balance of the gut microbiota, which is thought to be disrupted in Ulcerative Colitis (UC) patients.
... Review 1
14 studies reviewed (CRD42023478988), total of 600 patients. Higher odds of clinical and endoscopic remission compared to controls. Similar odds between FMT and control groups. Enhanced with pre-treatment using biologics, steroids, or methotrexate. Oral delivery and pooled donors increased remission odds. Studies included up to November 2023 (1).
...Review 2
13 randomized controlled trials (RCTs) with 580 patients. Clinical remission was better in the FMT group [RR = 1.73; 95% CI = (1.41, 2.12); P < 0.00001]. Endoscopic remission was better in the FMT group [RR = 1.74; 95% CI = (1.24, 2.44); P = 0.001]. No significant difference in adverse reactions between groups [RR = 1.00; 95% CI = (0.86, 1.15); P = 0.96]. FMT shows potential for inducing clinical remission in UC. Challenges remain in achieving endoscopic remission and maintaining long-term remission. Safety concerns require measures to improve safety and success rates. Studies included up to March 2023 (3).
...Review 3
12 randomized controlled trials (RCTs) with 544 participants. Evidence quality: Moderate to high (GRADE system). Findings from re-meta-analysis:
...Review 4
Six double-blind randomized controlled trials (RCTs) with 324 adult patients with active ulcerative colitis. FMT significantly induces combined clinical and endoscopic remission compared to placebo (Odds Ratio: 4.11; 95% CI: 2.19-7.72; P < .0001). No significant differences in outcomes based on:
* Pooled vs. single stool donors (P = .71)
* Fresh vs. frozen FMT (P = .35)
* Different delivery routes or frequencies (P = .80 and .48)
Pre-FMT antibiotics, bowel lavage, concomitant biologic therapy, and topical rectal therapy did not affect remission rates (P values: .47, .38, .28, .40). FMT shows clinical and endoscopic benefits in short-term treatment of active ulcerative colitis with a safety profile similar to placebo. Future Directions: Standardize study protocols and explore maintenance therapy in future RCTs. Studies included up to December 2021 (2)
...Review 5
Four randomized clinical trials with 277 participants (Cochrane review CD012774) assessed the efficacy of Fecal Microbiota Transplantation (FMT) for treating active mild to moderate Ulcerative Colitis (UC) in adults. Rectal and nasoduodenal routes for FMT administration were used. Three studies had a low risk of bias, while one had an unclear risk.
Results indicated that FMT doubled the clinical remission rates in UC patients compared to controls, with 37% achieving remission at 8 weeks versus 18% in the control group. Relapse data at 12 weeks showed no relapses in FMT participants compared to 20% in controls. Serious adverse events were similar between groups, with 7% in FMT and 5% in controls. Common adverse events included abdominal pain, nausea, and infections. Clinical response at 8 weeks was higher in FMT participants (49%) compared to controls (28%). Endoscopic remission favored FMT, with 30% achieving it versus 10% in controls. Overall, evidence certainty was low to moderate.
Fecal microbiota transplantation may increase the proportion of participants achieving clinical remission in UC. However, the number of identified studies was small and the quality of evidence was low. There is uncertainty about the rate of serious adverse events. As a result, no solid conclusions can be drawn at this time. Additional high-quality studies are needed to further define the optimal parameters of FMT in terms of route, frequency, volume, preparation, type of donor and the type and disease severity. No studies assessed efficacy of FMT for induction of remission in CD or in pediatric participants. In addition, no studies assessed long-term maintenance of remission in UC or CD. Future studies are needed to address the therapeutic benefit of FMT in CD and the long-term FMT-mediated maintenance of remission in UC or CD.
Fecal microbiota transplantation (FMT) may help achieve clinical remission in ulcerative colitis (UC), but current studies are limited and of low quality, leading to uncertainty about serious adverse events. More high-quality research is needed to determine optimal FMT parameters, such as route, frequency, and donor type. Studies included up to March 2018 (17).
...Review 6
Four randomized controlled trials (RCTs) with 277 adult patients with active ulcerative colitis. The combined results suggest that donor FMT can effectively induce remission in mild to moderately severe UC. However, the number of included studies was small, and the quality of evidence was low. No studies assessed FMT for maintenance of remission in UC. Studies included up to June 2017 (12)
ACTRN12613000236796
The results indicated a greater probability of achieving remission at the eight-week mark with the donor FMT. However, additional research is necessary to evaluate the long-term maintenance of remission and the safety of this treatment approach (8).
ACTRN12619000611123
Taking antibiotics and then using fecal microbiota transplantation by mouth helped patients with active ulcerative colitis go into remission (22)
NCT01545908
In the study, FMT was found to induce remission in a significantly higher percentage of patients with active UC compared to those who received a placebo (6).
NCT01650038
In this phase II trial, researchers found no statistically significant difference in clinical and endoscopic remission between patients with ulcerative colitis (UC) who received fecal transplants from healthy donors and those who received their own fecal microbiota. This lack of difference might be attributed to the limited number of participants (19)
NCT01896635
Intensive-dosing, multidonor fecal microbiota transplantation can lead to clinical remission and endoscopic improvement in patients with active ulcerative colitis. This treatment is associated with specific microbial changes that align with the observed outcomes. Consequently, fecal microbiota transplantation is emerging as a promising new therapeutic option for managing ulcerative colitis. Future research should focus on accurately determining the optimal treatment intensity and investigating the importance of donor–recipient matching based on microbial profiles (7, 15).
For high Candida abundance pre-Fecal Microbiota Transplantation (FMT) was associated with a clinical response, whereas decreased Candida abundance post-Fecal Microbiota Transplantation (FMT) indicated ameliorated disease severity. Our data suggest that Fecal Microbiota Transplantation (FMT) might reduce Candida and highlight the utility of mycobiota–focused approaches to identify Fecal Microbiota Transplantation (FMT) responders before therapy initiation (14).
NCT02390726
Daily encapsulated cFMT may extend the durability of index FMT‑ind changes in gut bacterial community structure. There may be an association between MAIT cell cytokine production and clinical response to FMT in UC populations. Oral frozen encapsulated cFMT is a promising FMT delivery system. It may be preferred for long-term treatment strategies in UC and other chronic diseases. Further evaluations will need to address home storage concerns. Larger trials should explore the benefits of cFMT. They should also determine its long-term impacts on the colonic microbiome (10).
NCT02734589
The ulcerative colitis exclusion diet (UCED) on its own resulted in higher rates of clinical remission and mucosal healing compared to single-donor, low-frequency fecal transplantation (FMT). Additionally, incorporating donor dietary conditioning did not enhance the outcomes of FMT (23)
NCT03104036
A trial compared FMT with 5-aminosalicylic acid (5-ASA) enemas in 20 analyzed patients with active left-sided UC. FMT non-inferiority was confirmed with a 10% margin (95% CI: −7.6%, 48.9%). Adverse events occurred in 12 FMT (57%) and 13 5-ASA (59%) patients. Increased microbial diversity was observed 3 months after FMT associated with increased abundance of: Lachnospiraceae, Ruminococcaceae, Clostridiaceae (phylum Firmicutes), Bifidobacteriaceae, Coriobacteriaceae (phylum Actinobacteria), Faecalibacterium, Blautia, Coriobacteria, Collinsela, Slackia, Bifidobacterium. FMT is effective for left-sided UC and enhances microbiome diversity. Further research is needed to optimize donor and patient selection for FMT (18, 24).
NCT03561532
There were no significant differences in the number of relapses between the study groups at the 12-month follow-up. Consequently, our findings do not endorse the use of a single-dose FMT for maintaining remission in ulcerative colitis (UC) (4).
NCT04373473
No published results are available for NCT04373473 (PRIM-DJ2727) in ulcerative colitis as of May 2026
NCT05786404
No published results were found as of May 2026
PediFETCh - Fecal Microbiota Transplantation (FMT) & Ulcerative Colitis (UC)
Despite facing numerous challenges, provides the first pilot randomized controlled trial (RCT) evidence suggesting that fecal microbiota transplantation (FMT) could play a significant role in alleviating symptoms and reducing inflammatory markers in pediatric ulcerative colitis (UC) (20)
XXX (1) - Fecal Microbiota Transplantation (FMT) & Ulcerative Colitis (UC)
The primary endpoint was not reached. However, maintaining FMT in patients who are in clinical remission may help sustain clinical, endoscopic, and histological remission in patients with UC (9).
XXX (2) - Fecal Microbiota Transplantation (FMT) & Ulcerative Colitis (UC)
The primary endpoint was not reached. However, maintaining FMT in patients who are in clinical remission may help sustain clinical, endoscopic, and histological remission in patients with UC (21).
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see also:
Fecal Microbiota Transplantation (FMT) & Inflammatory Bowel Disease (IBD)
Gut microbiota & Ulcerative colitis (UC)
Microbiome-based therapeutics & Ulcerative colitis (UC)
Ulcerative colitis (UC) & Drugs/Treatments