Fecal Microbiota Transplantation Using a Single Super Donor Is Effective in IBS

Fecal microbiota transplantation (FMT) using a single super donor is an effective treatment for patients with irritable bowel syndrome (IBS), according to new research presented at United European Gastroenterology (UEG) Week 2019.

To assess the effect that a transplantation from a single donor with a favorable microbiota profile has on a recipient’s IBS symptoms, Magdy El-Salhy, MD, PhD, and colleagues conducted a double-blind study that included 164 patients with IBS.

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Each participant was randomly assigned to receive placebo, a 30-g donor transplantation solution, or a 60-g donor transplantation solution.

Participants were considered to have experienced a reduction in IBS symptoms if their IBS- Severity Scoring System (IBS-SSS) total score decreased by 50 points or more 3 months after FMT. The factors assessed via the IBS-SSS included abdominal symptoms, fatigue, and quality of life.

Overall, 23.6% of patients in the placebo group, 75.9% in the 30-g FMT group, and 87.3% of patients in the 60-g FMT group responded to FMT and experienced a significant improvement in fatigue and quality of life.

A higher percentage of patients in the 30-g FMT (35.2%) and 60-g FMT (47.3%) groups experienced symptom remission compared with patients in the placebo group (5.5%).

Compared with participants in the placebo group (21.8%), participants in the 30-g FMT group (53.7%) and 60-g FMT group (52.7%) also had a significant improvement in fatigue.

Additionally, a greater percentage of participants who received either 30-g FMT (61.1%) or 60-g FMT (58.2%) had improved IBS-Quality of Life scores compared with patients who received placebo (7.3%).

The researchers evaluated for a reduction in the participants’ Dysbiosis Index, as well as for a change in the intestinal bacterial profile 3 months following FMT. The Dysbiosis Index did not decrease significantly among any of the groups. The intestinal bacterial profiles changed among both FMT groups but not the placebo group.

“FMT is an effective treatment for patients with IBS. A well-defined donor with normal [Dysbiosis Index] and favorable specific microbial signature is essential for the success of FMT,” the researchers concluded. “Response to FMT increases with increased dose. There was a significant difference in the intestinal bacterial profile between responders and non-responders, which might be used to identify candidates for FMT.”

—Colleen Murphy

References:

1. El-Salhy M, Hatlebakk JG, Gilja OH, Kristoffersen A, Hausken T. Effects of faecal microbiota transplantation in patients with irritable bowel syndrome (IBS): a randomised, double-blind placebo-controlled study [abstract OP004]. Presented at: UEG Week 2019; October 19-23, 2019; Barcelona, Spain.