Fecal Microbiota TransplantFecal Microbiota Transplant for Patients With Chronic Pouchitis

Inclusion Criteria:

Patients age 18 or greater with UC who have undergone TPC with IPAA and have one of the following chronic pouchitis phenotypes, each defined as:

• Chronic antibiotic dependent pouchitis:
• The need for continuous antibiotic therapy (>4 weeks) to maintain clinical remission and a history of at least 2 attempts in the last 24 months to stop antibiotic therapy resulting in pouchitis episodes, OR
• Active pouchitis with a modified Pouchitis Disease Activity Index (mPDAI) ≥5 and a history of ≥4 antibiotic therapies in the last 12 months
• Chronic antibiotic refractory pouchitis:
• Active pouchitis with a modified Pouchitis Disease Activity Index (mPDAI) ≥5 with no response to antibiotics
• Crohn's disease like pouch inflammation on biologic or small molecule therapy with persistent symptoms:
• Pre-pouch ileal inflammation, strictures, and/or fistulae, AND
• Active biologic or small molecule therapy, AND
• Persistent symptoms with mPDAI clinical sub-score ≥ 2

Exclusion Criteria:

Patients with UC who underwent TPC with IPAA and meet one of the following criteria will be excluded:

• Allergy to vancomycin, metronidazole, or ingredients present in the FMT
• Women who are breastfeeding
• Women who are pregnant
• Participants with fever > 100.4F/38C or other signs of active illness
• Active treatment with biologics (infliximab, adalimumab, golimumab, vedolizumab, ustekinumab)
• Active treatment with immunomodulators (azathioprine, 6-mercaptopurine, methotrexate), steroids or any investigational drugs
• Crohn's disease like pouch inflammation
• Active enteric infection
• Isolated cuffitis
• Clinically significant strictures of the pouch inlet or outlet
• Participation in a clinical trial in the preceding 30 days
• Any condition that the physician investigators deems unsafe, including other conditions or medications that the investigator determines will put the participant at greater risk from FMT