The objectives of this report are: • to review the prevalence, incidence, risk factors, and consequences of Clostridium difficile- associated disease (CDAD) and ulcerative colitis, • to examine clinical research evidence on the safety and efficacy/effectiveness of fecal transplantation compared to standard care in the prevention and treatment of patients with CDAD or ulcerative colitis, and • to p [...] Fecal Transplantation for the Treatment of Clostridium Difficile-Associated Disease and/or Ulcerative Colitis xiii INTRODUCTION This rapid assessment report was prepared in response to a request from the Alberta Health Technologies Decision Process, Alberta Health and Wellness, about scientific evidence on the safety and effectiveness of fecal transplantation in the prevention and treatment of C. [...] Any factors associated with the alteration of normal intestinal microflora increases the risk of C. difficile colonization after exposure to the bacteria.23 Disruption of the normal flora with broad-spectrum antimicrobial agents increases susceptibility of the intestinal tract to the overgrowth of C. difficile.24 As shown in Table 2, the most common risk factor is exposure to antibiotics, especial [...] The prolonged use of steroids may result in the loss of the normal physiological balance among C. difficile and other organisms in the intestinal flora.52 Fecal Transplantation for the Treatment of Clostridium Difficile-Associated Disease and/or Ulcerative Colitis 9 TECHNOLOGY − FECAL TRANSPLANTATION Definition Fecal transplantation, also known as fecal bacteriotherapy, fecal transfusion, or human [...] The use of broad-spectrum antibiotics can alter the balanced ecology of normal colonic flora, and the consequential overgrowth of pathogenic C. difficile strains leads to increased production of toxins that cause diarrhea and other associated symptoms.15,36 The fundamental challenge in treating CDAD is not the presence of the pathogenic organism per se but, rather, the relative paucity of protecti