In a Medscape interview, Colleen Kelly, MD, a gastroenterologist at Brigham and Women’s Hospital and Harvard Medical School faculty member, discusses the evolving role of fecal microbiota transplantation (FMT), research beyond C. difficile, obesity in IBD, and the importance of preserving physician-patient connection.
Kelly notes that FDA-approved FMT products have largely replaced conventional FMT for preventing recurrent C. difficile infection, but acute severe or fulminant CDI remains a therapeutic gap, particularly for critically ill patients who may require multiple doses. Researchers are exploring open-label and registry data because placebo-controlled trials in this population raise ethical challenges.
She also discusses an ongoing multicenter study investigating FMT in Crohn’s disease, although enrollment has been slow and results are still some way off.
A second theme is the growing intersection of obesity and IBD, including the challenges of pharmacologic and bariatric treatment in patients with complex Crohn’s disease.
The interview ultimately focuses on the human side of gastroenterology, with Kelly arguing that increasing reliance on computers and digital workflows can make physician-patient interactions less personal.