Irritable Bowel Syndrome is a complex GI-condition with many causes and potential treatments. On this page, we will share some scientific journal articles related to FMT as a therapy for patients with IBS.
Article Abstract 1:
Olga C. Aroniadis; Lawrence J. Brandt
Curr Opin Gastroenterol. 2013;29(1):79-84.
“Treatment of Gastrointestinal Diseases: Irritable Bowel Syndrome and Chronic Constipation
Postinfectious IBS has been reported in up to 30% of patients with acute gastroenteritis, suggesting that the pathogenesis of IBS may be intimately linked to an altered intestinal microbiota.[47–49] The composition of the intestinal microbiota in patients with IBS has not been extensively studied, however, patients with constipation-predominant IBS have been shown to increase population of sulphate-reducing bacteria compared with healthy controls. Probiotics can restore the intestinal microbiota in patients with IBS[49,51] and result in improvement of postinfectious IBS in animal models; FMT, however, may prove more beneficial, as donated feces, in a sense, are the ultimate human probiotic.
In a case series of 55 patients with IBS and IBD treated with FMT, cure was reported in 20 (36%), decreased symptoms in nine (16%) and no response in 26 (47%) patients. In another series, 45 patients with chronic constipation were treated with colonoscopic FMT and subsequent fecal enema infusions, 89% of whom (40 of 45 patients) reported relief in defecation, bloating and abdominal pain immediately after the procedure. Normal defecation, without laxative use, persisted in 18 of 30 patients (60%) contacted 9–19 months later.
Article Abstract 2:
Efficacy analysis of fecal microbiota transplantation in the treatment of 406 cases with gastrointestinal disorders
To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for gastrointestinal disorders.
Retrospective analysis of the clinical data of 406 patients who underwent FMT from May 2014 to April 2016 in the Intestinal Microenvironment Treatment Centre of Nanjing General Hospital was performed, including patients with constipation(276 cases), recurrent Clostridium Difficile infection (RCDI, 61 cases), ulcerative colitis(44 cases), irritable bowel syndrome (15 cases) and Crohn’s disease(10 cases). Donors were completely unrelated, 18- to 50-year-old non-pregnant healthy adult, with healthy lifestyle and habits, without taking antibiotics, probiotics and other probiotics history within 3 months. There were three routes of FMT administration: patients received 6 days of frozen FMT by nasointestinal tube placed in the proximal jejunum under gastroscope (319 cases); patients received capsules FMT per day for 6 consecutive days (46 cases) or once 600 ml of treated fecal liquid infusion into colon and terminal ileum by colonoscopy(41 cases).
Clinical cure rate and improvement rate of different diseases receiving FMT were respectively as follows: RCDI was 85.2% (52/61) and 95.1%(58/61); constipation was 40.2%(111/276) and 67.4%(186/276); ulcerative colitis was 34.1%(15/44) and 68.2% (30/44); irritable bowel syndrome was 46.7% (7/15) and 73.3% (11/15) and Crohn disease was 30.0%(3/10) and 60.0%(6/10). RCDI had the best efficacy among these diseases(P<0.01). There was no significant difference between the three routes of FMT administration(P=0.829). The clinical cure rate and improvement rate of different routes were 43.3%(138/319) and 58.6% (187/319) respectively in nasogastric transplantation group, 41.5%(17/41) and 61.0%(25/41) in colonoscopy group, 37.0%(17/46) and 63.0% (29/46) in the capsule transplantation group. There was no serious adverse event during the follow-up. The most common side effects were respiratory discomfort (27.3%, 87/319) and increased venting (51.7%, 165/319) in nasogastric transplantation group. Diarrhea was the most common complication in colonoscopy group (36.6%, 15/41). The main symptoms were increased venting (50.0%, 23/46) and nausea(34.8%, 16/46) in oral capsule group. Side effect symptoms disappeared after the withdraw of nasogastric tube, or at the end of treatment, or during hospitalization for 1-3 days.
FMT is effective for many gastrointestinal disorders. No significant adverse event is found, while the associated mechanism should be further explored.
Article Abstract 3:
Healio, Gastroenterology Report
May 8, 2017
“It seems that FMT has a beneficial effect on symptom scores and on quality of life in IBS patients. However, this effect is also observed in the placebo group, although to a lesser extent, but this indicates that placebo controlled studies are definitely necessary in IBS patients,” Savanne Holster, PhD, of the Nutrition-Gut-Brain Interactions Research Center at Örebro University in Sweden, said during her presentation.
Holster and colleagues randomly assigned 16 patients with IBS to receive FMT via colonoscopy using either donor material or their own fecal material as placebo. The researchers assessed symptom scores and quality of life before and after the procedure.
IBS Symptom Severity Scores in patients who received donor FMT dropped significantly at 4 and 8 weeks after treatment compared with baseline (P < .01 for both), while there were no significant changes observed in the placebo group. There were also no significant differences observed in IBS-SSS between the treatment and placebo groups.