Introduction Fecal Microbiota Transplantation (FMT) is an effective and safe therapy for antibiotic-resistant Clostridium Difficile Infection (CDI). However, FMT long-term outcomes are unknown. Therefore, in this study, we evaluated long-term FMT outcomes especially in patients with IBD. Methods All patients with recurrent and refractory CDI who underwent FMT between December 2012 and February 2017 were included in this study. Patients were contacted 48 hours and 90 days after FMT. Results Eighty-two patients with recurrent or refractory CDI and subsequent FMT treatment were identified. Four of them had severe CDI and were reported separately in a single case series, 1 patient had no documentation of symptoms before and after FMT, therefore excluded from the study. Out of 77 patients that were included in the analysis 21 (27.2%) had concurrent IBD. 90 days after FMT, 10 of the 21 patients with IBD had abdominal pain, 14 (66.6%) had diarrhea, 7 (33.3%) had positive testing for CDI, 3 (14.2%) of them required repeat FMT and all 3-tested negative thereafter. 1 of the positive tested was asymptomatic, 1 required colectomy secondary to toxic megacolon, 6 (28.5%) patients had IBD flares documented after 90 days. Of the 56 (72.2%) non-IBD patients only 8 (14.2%) reported recurrence of abdominal pain 90 days after FMT. Most patients had moderate diarrhea prior to FMT, 18 (14.2%) complained of diarrhea after FMT, most patients did not have documented eradication of Clostridium difficile testing following FMT. 3 (5.3%) patients required repeat FMT, 1 had clearance, 1 did not have any testing, and 1 remained positive. Discussion FMT was effective in the eradication of CDI in patients with and without IBD, but with no significant symptoms improvement in IBD patients. Future Randomized control studies are needed to examine the long-term progression of IBD and quality of life in patients treated with FMT compared to standard therapy of antibiotics for recurrent CDI.
