Fecal-Microbiota Transplantation Improves IBS Symptoms

By Will Boggs MD

December 30, 2019

NEW YORK (Reuters Health) - Fecal-microbiota transplantation (FMT) improves symptoms and quality of life in patients with irritable-bowel syndrome (IBS), researchers from Norway report.

IBS affects an estimated 11.2% of the global population, they note in the journal Gut. Earlier studies of FMT in patients with IBS have yielded conflicting results.

Dr. Magdy El-Salhy, of Stord Hospital and the University of Bergen Faculty of Medicine and Dentistry, and colleagues investigated the effect of FMT on IBS symptoms three months after treatment in a double-blind, placebo-controlled, randomized trial of 165 patients with moderate-to-severe IBS.

Patients assigned to FMT received fecal transplants from a single, healthy, nonsmoking male donor who was not taking any medication and whose dysbiosis index (DI) was 1, indicating normobiosis.

The primary endpoint, a reduction in the IBS-Severity Scoring System (SSS) total score (which can range from 0 to 500) of at least 50 points, was achieved by 76.9% of patients who received 30 g FMT and by 89.1% of patients who received 60 g FMT, compared with only 23.6% of patients who received placebo (P<0.0001 for both comparisons).

Total-score improvements were similar for patients with diarrhea-predominant, constipation-predominant and mixed subtypes of IBS.

The secondary endpoint, change in the DI, did not differ significantly between the FMT and placebo FMT groups, but responders in the FMT groups had higher levels of Eubacterium biforme, Lactobacillus species, and Alistipes species and lower levels of Bacteroides species after transplantation.

FMT recipients also had significant improvements in abdominal symptoms, fatigue and quality of life, compared with placebo FMT recipients.

"FMT is an effective treatment for patients with IBS," the researchers conclude. "The response to FMT increases with the dose."

The study had no commercial funding, and the researchers report no conflicts of interest.

Dr. El-Salhy did not respond to a request for comments.

SOURCE: https://bit.ly/2Mxxd52 Gut, online December 18, 2019.