Physicians Must Discuss Potential Long-Term Risks of Fecal Microbiota Transplantation to Ensure Informed Consent

textabstractFecal microbiota transplantation (FMT) for patients with multiply recurrent Clostridium difficile (C. difficile) infections despite standard medical treatment is considered both effective, with approximately 90% cured (Aroniadis et al. 2016), and acceptable regarding short-term safety concerns. Doctors who perform FMT often also receive requests for the treatment from patients suffering from a range of other conditions, including irritable bowel syndrome and inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis. Sometimes patients request FMT prior to accepting standard treatment options, and thus seem to prefer it to standard of care. Other patients request FMT for non-gastrointestinal disorders, in which disease etiology and activity may be more tenuously linked to gut bacteria. These examples highlight the growing popularity of FMT, which in turn gives rise to concerns regarding appropriate informed consent for the procedure.