Fecal microbiota transplantation is an effective treatment for patients with irritable bowel syndrome, but the fecal sample must come from a “super donor,” according to study results presented at UEG Week.
“Microbiota dysbiosis is thought to play an important role in the pathophysiology of IBS,” Magdy El-Salhy, MD, PhD, professor of gastroenterology and hepatology at Bergen University in Norway, said in a press release. “However, previous studies investigating FMT in this condition have produced conflicting results.”
El-Salhy tested the efficacy of FMT for IBS using stool samples from a single “super donor,” a Caucasian man aged 36 years. The donor was healthy, had a normal BMI, exercised regularly, was born via vaginal birth and was breast fed. He was not taking any medications, only received three courses of antibiotics in his lifetime and regularly took dietary supplements.
Researchers randomly assigned 164 patients with IBS to receive either 30 grams or 60 grams of FMT or placebo. The primary outcome of the study was a reduction in IBS symptoms, defined as a decrease in the IBS-Severity Scoring System (IBS-SSS) total of at least 50 points 3 months after FMT. Secondary endpoints included reduction in dysbiosis index as measured by the GA-map Dysbiosis Test (Genetic Analysis AS).
Researchers found that more patients in the 30-gram (75.9%) and 60-gram (87.3%) FMT groups achieved response compared with placebo (23.6%). Patients who received FMT also experienced improvements in fatigue and quality of life.
Additionally, 35.2% of patients in the 30-gram group and 47.3% in the 60-gram group achieved symptom remission — defined as IBS-SSS improvement of at least 175 points — compared with just 5.5% in the placebo group.
While the dysbiosis index did not significantly decrease in any FMT or placebo groups, investigators found that intestinal bacterial profiles changed in both groups that received FMT but not the placebo group.
“We got lucky when we found our donor after screening several other candidates, and we hope the selection criteria we used will help other groups find similar individuals,” El-Salhy said in the release. “The use of frozen feces eliminates the logistical problems associated with FMT involving fresh feces, making it possible to establish bio-banks for the routine use of FMT in clinical practice.” – by Alex Young
El-Salhy M, et al. Abstract OP004. Presented at: UEG Week; Oct. 19-23, 2019; Barcelona.
Disclosure s: The authors report no relevant financial disclosures.