Hamilton researchers are conducting a ground-breaking new trial looking at fecal transplants to help treat inflammatory bowel disease (IBD) in children.
Fecal transplant treatments have been found to be beneficial for adults with IBD, but the pediatric fecal transplant for ulcerative colitis trial - or PediFETCh - is the first such study for children with IBD in Canada, and the first randomized controlled trial of its kind in the world.
Dr. Nikhil Pai, principal investigator for the PediFETCh trial, says the study is particularly significant given that rates of IBD in children in Ontario are among the highest in the world and rising steadily. Dr. Pai is also a pediatric gastroenterologist in the Centre for Child & Youth Digestive Health at McMaster Children's Hospital and assistant professor of pediatrics at McMaster University's Michael G. DeGroote School of Medicine. Study collaborators include Dr. Christine Lee (Division of Infectious Disease at St. Joseph's Hospital in Hamilton), Dr. Paul Moayyedi (Division of Adult Gastroenterology at McMaster University), and Jelena Popov, research coordinator, with support from the Farncombe Family Digestive Health Research Institute at McMaster University.
"One in 150 Canadians have inflammatory bowel disease," says Dr. Pai. "About 30 per cent of people with IBD are diagnosed before the age of 20, and Ontario has one of the highest rates of childhood-onset IBD in the entire world. Over the past five years, IBD has increased most rapidly in children under the age of 10 years old."
Ulcerative colitis (UC) - one of a group of diseases known as inflammatory bowel disease - can have a severe impact on a child's life, leading to stunted growth; debilitating pain; negative effects on the liver, bones, skin and eyes; and the need for surgery and frequent hospitalizations.
Fecal transplants involve the transfer of fecal material from a healthy donor into a patient's gastrointestinal tract through an enema, endoscope, or catheter. In adults, repopulating the gut with healthy bacteria has been shown to treat patients with recurrent infections from a common, hospital-acquired bacteria known as C. difficile. A 2015 McMaster University study of adult IBD patients was the first to show that fecal transplants can improve symptoms of ulcerative colitis.
"The PediFETCh study will help determine - for the first time - whether fecal transplants can be a viable treatment for children with UC who cannot control their disease with their current medications, or who want to avoid moving onto higher doses, different medications, or surgery."
"This is a potentially life-changing treatment option for kids and teens affected by this increasingly common disease."
Patients six to 17 years old who have been diagnosed with ulcerative colitis are eligible for recruitment to the PediFETCh study.