Chronic inflammatory enteropathy: faecal microbiota transplantation in clinical practice

Abstract

Chronic inflammatory enteropathy is an umbrella term that encompasses various inflammatory disorders of the gastrointestinal tract. In the absence of identifiable underlying infectious, neoplastic or metabolic causes, chronic or recurrent signs of gastrointestinal disease and histopathological evidence of mucosal inflammation are the hallmarks of chronic inflammatory enteropathy. Subgroups of chronic inflammatory enteropathy are retrospectively categorised as food-responsive, immunosuppression-responsive, small intestinal dysbiosis or non-responsive based on the selective response to therapeutic trials. Small intestinal dysbiosis is an overarching term used to describe derangement of the small intestinal microbiota caused by an abnormal proliferation of bacteria and/or change in bacterial species present in the small intestinal lumen. The pathogenesis of chronic inflammatory enteropathy remains elusive, although current hypotheses emphasise the role of adverse immune responses to dietary and microbial antigens thought to arise from immune system dysregulation, genetic susceptibility and intestinal dysbiosis. The gastrointestinal tract of dogs is colonised by a vast population of microorganisms, known as the intestinal microbiota, which is composed of viruses, fungi, bacteria and protozoa. Clinical use of faecal microbiota transplantation in promoting normobiosis has been gaining popularity within the field of canine gastroenterology. This modifies the intestinal bacterial microbiota and has shown promise as an adjunctive treatment of enteric disease, associated with a faster resolution of diarrhoea and enhanced clinical recovery.