SAN DIEGO — Orally delivered fecal microbiota transplantation did not help reduce symptoms in patients with diarrhea-predominant irritable bowel syndrome whether or not they were pre-treated with antibiotics, according to data presented at Digestive Disease Week.
Prashant Singh, MD, of the department of gastroenterology at Beth Israel Deaconess Medical Center, said that gut dysbiosis could be a critical factor in the development of IBS-D, and while FMT treatment for IBS has been the subject of many studies, they have led to conflicting results.
“We don’t know the best technique to administer FMT to bring the long-lasting stool engraftment,” Singh said in his presentation. “It is also unclear if antibiotic treatment prior to FMT has an impact on GI symptoms or engraftment of the fecal microbiota transplant.”
Researchers conducted a double-blind, placebo-controlled trial comprising 44 patients with moderate to severe IBS-D, defined as IBS severity scoring system (IBS-SSS) 175 or greater. They randomly assigned patients to four groups; FMT alone (n = 11), FMT following a 7-day pre-treatment course of ciprofloxacin and metronidazole (n = 10), FMT following a 7-day pre-treatment course of rifaximin (n = 11), or a placebo FMT (n = 12).
Investigators assessed IBS-SSS, quality of life (IBS-QOL), IBS-Global improvement scale (IBS-GIS) and adequate symptom relief at week 1 and week 10.
Patients in all four groups experienced similar changes in IBS-SSS scores from baseline to week 1 and 10. A comparable proportion of patients in all four groups also experienced adequate relief, mean IBS-GIS and change in IBS-QOL scores at both time points.
The change in IBS-SSS scores from baseline was also comparable in the three FMT groups combined, compared with placebo.
“Pre-treatment with antibiotics before FMT did not have any significant impact on clinical outcomes in IBS-D patients,” Singh concluded. “At this time, we are looking at the microbiome data from week 1 and week 10 and comparing them with baseline to see if we can correlate the changes in microbiome with symptom improvement.” – by Alex Young
Singh P, et al. Abstract 1,101. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Singh reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.