Standardized Microbiota Transplant Therapy in Crohn's Disease

Eligibility Criteria

• * Able and willing to provide informed consent.
• * 18-89 years of age.
• * English speaking.
• * Diagnosis of CD based on typical clinical and histologic features.
• * Active disease on endoscopy:
• * SES-CD \>= 6
• * SES-CD \>= 4 for isolated ileal disease
• * Current CD therapies are in the maintenance phase of dosing at the time of randomization.
• * Any ongoing CD therapy (apart from steroid use) must be at stable doses for 4 weeks prior to randomization and remain stable over study course.
• * Steroid use 20mg or less by 5 days prior to randomization.
• * Steroid use stipulations:
• * Prednisone must be tapered below 20mg after 7 days.
• * Any use of budesonide over the study period is allowed although tapering is encouraged.
• * Rescue medications: Steroid courses (up to 40mg for two weeks with a planned taper) are allowed at the discretion of the treating provider. Study drug therapy will be stopped on a case-by-case basis on discussion with the participant and treating provider.
• * Women who are not post-menopausal (at least 12 months of non-therapy induced amenorrhea) or surgically sterile (e.g., absence of ovaries and/or uterus) must remain abstinent or use a highly effective form of birth control (e.g., oral contraception, transdermal patch, barrier, intrauterine device).
• * Able to comply with study measures in the opinion of the investigator.
• * Extensive bowel resection: i.e., subtotal colectomy or substantial removal of small bowel where short bowel syndrome could be a concern.
• * Documented gastroparesis
• * History of pylorus non-preserving gastric surgery, e.g., Roux-en-Y gastric bypass.
• * Symptomatic stricture defined as a stricture that:
• * Cannot be traversed by the colonoscope,
• * Requires intervention to be traversed,
• * Is otherwise responsible for the predominant clinical picture, in the opinion of the investigator.
• * Presence of ileostomy or colostomy.
• * Entero-vesicular fistula (i.e., fistula from bowel to bladder).
• * Suspicion of ischemic colitis, radiation colitis or microscopic colitis.
• * Diagnosis of ulcerative colitis.
• * Active or untreated infection.
• * Adenomatous polyps that have not been removed.
• * Use of antibiotics within 14-days of randomization.
• * Current pregnancy.
• * Current breastfeeding or planning to breastfeed over the study period.
• * History of anaphylactic food allergies.
• * End stage liver disease or cirrhosis.
• * Anticipated need for antibiotics over the study period.
• * Anticipated surgical procedure over the study period.
• * An absolute neutrophil count \<500 cell/µL.
• * Diagnosis of a primary immunodeficiency.
• * Active malignancy requiring the use of chemotherapeutic agent (except for localized non-melanomatous skin cancers).
• * Patients receiving active cytotoxic therapy for solid tumors and hematologic malignancies.
• * Any solid organ transplant within 6 months of randomization.
• * Use of chimeric antigen receptor T-cell therapy or hematopoietic cell transplant within the past 12 months
• * Life expectancy \>=6 months.