Managing refractory cases of Inflammatory Bowel Disease (IBD) can be a significant challenge. When patients fail to respond to standard treatments such as steroids, thiopurines, and methotrexate, it presents a serious hurdle in the journey to achieve remission. The usual next step in treatment often involves the use of biologic therapies or Janus kinase (JAK) inhibitors. But what if those too fail to yield results?
In recent years, a promising combination of therapies has emerged for these particularly stubborn cases: Anti-Microbial Anti-Inflammatory Therapy (AMAT) and Fecal Microbiota Transplantation (FMT). While they may not be the first strategies that come to mind in managing IBD, increasing evidence supports their potential as effective treatments for cases unresponsive to conventional therapies.
AMAT use of combination of antibiotics. This approach aims to modify the gut microbiota, reducing the abundance of harmful bacteria and inflammation-inducing microbes that contribute to IBD symptoms.
FMT, on the other hand, involves the transplantation of fecal matter from a healthy donor into the patient's gut. This procedure helps restore a balanced microbiota, fostering a gut environment that can support healthy immune responses and promote gut healing.
At the Centre for Digestive Diseases (CDD), we've incorporated the combined approach of AMAT and FMT for managing refractory IBD cases, and the results have been promising. We've witnessed a response rate of 65%, with patients achieving full or near remission - an encouraging outcome for those who had previously seen little improvement with traditional IBD treatments.
These findings underscore the potential of alternative strategies like AMAT and FMT for tackling refractory IBD. While there's still much to learn about these treatments, the preliminary results point to a promising future. Our hope is that with continued research and clinical practice, more patients will find relief from their symptoms and reach the goal of full remission.
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