Singh JP, Aleissa M, Chitragari G, Drelichman ER, Mittal VK, Bhullar JS. Uncovering the role of microbiota and fecal microbiota transplantation in Crohn’s disease: Current advances and future hurdles. World J Methodol 2025; 15(4): 106148 [DOI: 10.5662/wjm.v15.i4.106148]
Corresponding Author of This Article
Jai P Singh, Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States. drjp04@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Methodol. Dec 20, 2025; 15(4): 106148 Published online Dec 20, 2025. doi: 10.5662/wjm.v15.i4.106148
Uncovering the role of microbiota and fecal microbiota transplantation in Crohn’s disease: Current advances and future hurdles
Jai P Singh, Maryam Aleissa, Gautham Chitragari, Ernesto Raul Drelichman, Vijay K Mittal, Jasneet Singh Bhullar
Jai P Singh, Maryam Aleissa, Gautham Chitragari, Ernesto Raul Drelichman, Vijay K Mittal, Jasneet Singh Bhullar, Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States
Co-corresponding authors: Jai P Singh and Jasneet Singh Bhullar.
Author contributions: Singh J wrote the manuscript; Aleissa M, Chitragari G, Drelichman E, and Mittal V assisted in writing the manuscript; Bhullar J designed research, wrote the paper. Singh J is the primary author, has undertaken the majority of the research work, including designing the paper, reviewing resources, and manuscript preparation.
Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jai P Singh, Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States. drjp04@gmail.com
Received: February 18, 2025 Revised: March 26, 2025 Accepted: April 17, 2025 Published online: December 20, 2025 Processing time: 168 Days and 9.9 Hours
Abstract
Crohn’s disease (CD) is an idiopathic, chronic, and recurrent inflammatory condition of the gastrointestinal tract. Recent studies suggest a potential role of gut microbiota in CD, particularly dysbiosis—an imbalance in gut bacteria. While dysbiosis is consistently observed in CD, it remains uncertain whether it is a cause or a consequence of the disease. Given its association with CD, the therapeutic potential of fecal microbiota transplantation (FMT) has been explored. This review examines the role of gut microbiota in CD, evaluates the therapeutic potential of probiotics and FMT, and highlights current research findings and limitations. Key studies on the relationship between gut dysbiosis, probiotics, and FMT in CD were analyzed, with a focus on randomized trials, meta-analyses, and clinical observations. Dysbiosis is a consistent feature of CD, but its causative role remains unclear. Probiotics, prebiotics, and synbiotics have shown no efficacy in inducing or maintaining remission in CD. FMT shows potential as a therapeutic option for CD, but its efficacy remains inconsistent and inconclusive. The variability in outcomes, including diminished effects over time despite repeated FMT, underscores the need for larger, well-controlled trials. Only one randomized controlled trial (RCT) has compared FMT with sham transplantation, but the sample size was very small. Other studies are limited by factors such as small sample sizes, lack of control groups, short follow-up periods, and inconsistent methodologies, making it challenging to draw definitive conclusions. While gut dysbiosis likely plays a role in CD pathogenesis, its causative role remains uncertain. Current evidence does not support FMT as a reliable treatment for inducing or maintaining remission in CD, though it appears generally safe. Larger, standardized, RCTs are necessary to clarify the therapeutic role of FMT in CD management.
Core Tip: This article reviews the role of microbiota in Crohn’s disease (CD) and the effects of fecal microbiota transplantation. CD is a chronic, relapsing condition with a complex pathogenesis involving genetic and environmental factors. The gut microbiota, crucial for various bodily functions, shows dysbiosis in CD, with a reduction in beneficial microbes. This review highlights recent developments in understanding microbiota’s role in CD and its potential in treatment strategies.
