Fecal transplants may lead to remission in some people with ulcerative colitis (UC), although more research is needed. Medications and lifestyle modifications are other ways to manage the condition.

Fecal transplants may become a future treatment for ulcerative colitis (UC), a type of inflammatory bowel disease (IBD).

Fecal transplants involve inserting stool from a donor into a recipient’s gastrointestinal (GI) tract to treat a condition or disease. Researchers believe the procedure may work by introducing good bacteria into the gut.

Some studies have shown promising results that may lead to treating UC with fecal transplants down the road.

Here’s what to know about fecal transplants for UC.

While not yet proven effective for ulcerative colitis, fecal transplants may work by adjusting the bacteria in your GI tract.

In a fecal transplant, healthcare professionals remove stool — which is full of good bacteria — from a donor without the condition, screen it for potential pathogens, strain it, liquefy it, and then insert it into a person in need of treatment for a particular condition. The procedure is not yet an approved therapy for ulcerative colitis outside use in clinical trials.

A fecal transplant can be done through:

Inside everyone’s digestive system lives a vast amount of healthy bacteria. These bacteria help us digest food but may also influence our health in many ways that researchers are still studying.

No one knows what causes UC, but one theory is that the bacteria in the colon — or gut microbiota — might play a role in the development of the condition.

Research from 2020 has shown that people with UC were missing certain gut microbes. Earlier research from 2018 also found links between intestinal bacteria and UC.

UC’s potential connection to the gut microbiota is the reason why some doctors think fecal transplants could help manage the disease.

Fecal transplants aren’t new. Doctors have long used the procedure to treat C. difficile (C. diff) colitis, an infection that can result from the long-term use of antibiotics.

C. diff may share some symptoms of UC, such as:

  • diarrhea
  • stools with blood or pus
  • abdominal pain and cramping
  • fever
  • weight loss

Researchers are working to understand whether fecal transplants can be as effective for UC as they are for C. diff.

Many of these studies are small and more research is needed to determine whether fecal transplant is an effective treatment for UC.

Research has not indicated that fecal treatments can cure UC, but they may help put the disease into remission for some people.

Remission occurs when UC symptoms get better or go away for a period of time, such as weeks, months, or even years.

Further study is needed to learn how long remission from UC may last after a fecal transplant. These procedures are not used to treat UC outside clinical trials.

No cure exists for UC, but there are many methods that can help manage the condition and reduce flares, including:

  • taking medications, like corticosteroids, biological drugs, and immunomodulators
  • using natural remedies, such as probiotics
  • maintaining a diet, especially avoiding foods that trigger flares
  • reducing stress levels
  • exploring surgery to remove the colon (with serious cases when medications don’t work)

Research from 2017, which included a total of 81 adults with UC, found that 27% of participants who received a fecal transplant went into remission within 8 weeks.

Only 8% of study participants who received a placebo experienced the same results. However, many participants in both groups had side effects like gastrointestinal symptoms. Severe reactions occurred in two people in the fecal transplant group and one person who received a placebo.

A 2018 pilot study on 20 people with UC found that fecal transplants prepared from two donors (to maximize bacteria diversity) were safe and somewhat effective. The results showed that within 4 weeks of receiving the fecal transplant, 35% of participants had an improvement in their symptoms and 15% went into remission from UC.

A 2019 study on 69 adults with mild to moderate UC also found similar results with fecal transplants from multiple donors. Nearly a third of the 38 participants in that study who received a fecal transplant created from the stools of three to four donors saw their UC go into remission within 8 weeks. Only 9% achieved remission after receiving a fecal transplant from a single donor.

In clinical trials and early studies, fecal transplants helped some people with UC have fewer symptoms or even achieve remission in 4–8 weeks. This research often involved a small sample size, so more study is needed to determine how long it takes before a stool transplant works for UC in larger groups of people.

When used to treat C. diff, stool transplants offer results within a few hours or days.

Research on stool transplants for UC is still in the early stages. Even though some studies have shown promising results, further study is needed to determine whether this is a safe and effective treatment for the condition.

In general, fecal transplant is a safe procedure when donors and samples undergo thorough screening. The most common side effects of the therapy include:

  • diarrhea
  • abdominal pain or cramps
  • bloating
  • gas
  • constipation

Researchers are studying whether fecal transplants can be used to treat UC. So far, early studies have shown promising results, with some participants experiencing remission from UC within 4–8 weeks of receiving a stool transplant. These studies have been small, though, so more research is needed.

It may take years before health authorities approve fecal transplants for UC.

While there’s no known cure for UC, medications and lifestyle measures may help with managing the condition. Consider talking with a healthcare professional to learn more about how to reduce flares and potentially put UC into remission.