Fecal transplantation: a path that gives hope but must to be taken with caution

During the 9th National IBD Conference under the aegis of the Afa (Association François Aupetit), I listened to Dr. Harry Sokol’s lecture, which inspired me some thoughts.

Dr. Harry Sokol, of the Saint-Antoine Hospital in Paris, presented encouraging results on fecal transplantation against “Clostridium difficile” infection, which represents a real therapeutic challenge.

In the field of IBD, the few studies presented unfortunately do not reveal conclusive results and Dr. Sokol rightly pointed out that patients with IBD are not candidates, in our current state of knowledge, for fecal transplantation. They can only have access to it in very limited clinical studies such as the one conducted in Saint-Antoine for Crohn’s disease.

This technique certainly opens new perspectives in the handling of the intestinal microbiota but I think it should be reserved for serious or rare situations, when conventional treatments fail and in the absence of therapeutic alternative. However, I remain skeptical about the risks of contamination which it may induce in the medium term, and for which it would be useful to conduct further studies. But in line with this research, for indications where the results are convincing and to optimize the chances of success, in my opinion the importance of the stool quality of the donor must be considered as well as the possibility of enriching the intestinal flora before transplantation by taking a quality probiotic such as Vivomixx.

In the same way, why not to improve the receiver’s microflora at the same time? To my knowledge no one has yet looked at these possibilities.