Transplantatie van fecale microbiota: Oude wijn in nieuwe zakken?

The intestinal microbiota play an important role in the homeostasis of the human body. A disruption of this delicate balance (commonly called "dysbiosis") is known to be involved in various gastrointestinal and systemic diseases such as antibiotic-associated diarrhea, inflammatory bowel disease and obesity. A restoration of this balance could exert therapeutic effects. Probiotics have been tried extensively, but fail to alter the gastrointestinal microbiota significantly. A fecal microbiota transplantation (FMT), in which healthy donor feces are transferred, remains a promising technique which could prove to be the answer. In this manuscript, the practical considerations of FMT are discussed and the current indications reviewed, most evidence being available for relapsing infections with Clostridium difficile.