Standardized Microbiota Transplant Therapy in Crohn's Disease

Inclusion 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).

  o Periodic abstinence and early withdraw are not acceptable methods.
* Able to comply with study measures in the opinion of the investigator.

Exclusion Criteria:

* 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.