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P847 Perceptions of faecal microbiota transplantation in a paediatric ulcerative colitis population (PediFETCh Trial)

J. Popov*1, E. Hartung2,3, L. Hill2,4, U. Chauhan5, N. Pai2

1University College Cork, College of Medicine & Health, Cork, Ireland, 2McMaster University, Paediatrics, Division of Gastroenterology & Nutrition, Hamilton, Canada, 3Humber College, School of Health Sciences, Toronto, Canada, 4University of Cape Town, Exercise Science & Sports Medicine, Faculty of Health Sciences, Cape Town, South Africa, 5Hamilton Health Sciences, Medicine, Division of Gastroenterology, Hamilton, Canada

Background

Faecal microbiota transplantation (FMT) has gained increasing attention in the treatment of IBD. Patient acceptance of FMT treatments is an important consideration, particularly in children. Existing data on patient perceptions of FMT is limited in its assessment of true experiences as respondents had not actually received FMT. The purpose of this study was to explore perceptions of FMT in a paediatric population undergoing FMT for UC or IBD-unclassified (IBD-U).

Methods

Paediatric patients enrolled in a randomised placebo-controlled trial of FMT for UC or IBD-U (PediFETCh Trial; NCT02487238), involving twice weekly enemas for 6 weeks, were invited to participate in face-to-face, semi-structured interviews. Interviews were recorded, transcribed verbatim, and analysed using open coding. A phenomenological approach was used to assess the experiences of each patient.

Results

A total of 8 patients were interviewed (Table 1). Major themes were: (i) understanding of FMT, (ii) psychosocial impacts of FMT, and (iii) comparing FMT perceptions pre- and post-treatment. Pre-treatment discomfort was associated with inoculation with ‘someone else’s poo’, novelty of the treatment, and physical discomfort of enema therapy. Post-treatment, patients felt that FMT was ‘manageable’, and ‘not a big deal at all’. There were no reported side effects from the treatment and no fear of experiencing side effects in the future. No faecal soiling accidents were reported post-treatment, and patients felt confident in their faecal continence. The majority (75%) of patients had a poor understanding of FMT therapy post-treatment, indicating a need for improved patient education. Sixty-seven per cent of patients chose to explore FMT because their current UC treatments were not working, 17% felt their decisions were heavily influenced by their parents, and 17% felt both factors contributed equally in their decision to pursue FMT. Participants were split between preference for FMT or medication therapy, with convenience of oral medications being an important factor, while others favoured FMT for its ‘more natural’ image and greater efficacy.

Conclusion

Three main themes were explored: psychosocial impacts, understanding of FMT, and experiences associated with FMT. These data offers valuable insight into methods for improving future patient experiences with FMT. Further analyses will assess parental experiences and explore differences between parent and child perceptions of these treatments.

Characteristics of interviewed patients.