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Efficacy of faecal microbiota transplantation for patients with irritable bowel syndrome in a randomised, double-blind, placebo-controlled study

Gut, 2020-05, Vol.69 (5), p.859-867 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ;2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 ;ISSN: 0017-5749 ;EISSN: 1468-3288 ;DOI: 10.1136/gutjnl-2019-319630 ;PMID: 31852769

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  • Title:
    Efficacy of faecal microbiota transplantation for patients with irritable bowel syndrome in a randomised, double-blind, placebo-controlled study
  • Author: El-Salhy, Magdy ; Hatlebakk, Jan Gunnar ; Gilja, Odd Helge ; Bråthen Kristoffersen, Anja ; Hausken, Trygve
  • Subjects: Abdomen ; Antibiotics ; Bacteria ; Biopsy ; Blood tests ; Diet ; Drug abuse ; Dysbacteriosis ; Electrolytes ; Fatigue ; Gut Microbiota ; Intestine ; Irritable bowel syndrome ; Medical research ; Microbiota ; Polyethylene glycol ; Principal components analysis ; Quality of life ; Questionnaires ; Researchers ; rRNA 16S ; Studies ; Substance abuse treatment ; Thyroid gland ; Transplantation ; Transplants & implants
  • Is Part Of: Gut, 2020-05, Vol.69 (5), p.859-867
  • Description: ObjectiveFaecal microbiota transplantation (FMT) from healthy donors to patients with irritable bowel syndrome (IBS) has been attempted in two previous double-blind, placebo-controlled studies. While one of those studies found improvement of the IBS symptoms, the other found no effect. The present study was conducted to clarify these contradictory findings.DesignThis randomised, double-blind, placebo-controlled study randomised 165 patients with IBS to placebo (own faeces), 30 g FMT or 60 g FMT at a ratio of 1:1:1. The material for FMT was obtained from one healthy, well-characterised donor, frozen and administered via gastroscope. The primary outcome was a reduction in the IBS symptoms at 3 months after FMT (response). A response was defined as a decrease of 50 or more points in the total IBS symptom score. The secondary outcome was a reduction in the dysbiosis index (DI) and a change in the intestinal bacterial profile, analysed by 16S rRNA gene sequencing, at 1 month following FMT.ResultsResponses occurred in 23.6%, 76.9% (p<0.0001) and 89.1% (p<00.0001) of the patients who received placebo, 30 g FMT and 60 g FMT, respectively. These were accompanied by significant improvements in fatigue and the quality of life in patients who received FMT. The intestinal bacterial profiles changed also significantly in the groups received FMT. The FMT adverse events were mild self-limiting gastrointestinal symptoms.ConclusionsFMT is an effective treatment for patients with IBS. Utilising a well-defined donor with a normal DI and favourable specific microbial signature is essential for successful FMT. The response to FMT increases with the dose. Trial registration www.clinicaltrials.gov (NCT03822299) and www.cristin.no (ID657402).
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0017-5749
    EISSN: 1468-3288
    DOI: 10.1136/gutjnl-2019-319630
    PMID: 31852769
  • Source: BMJ Journals (Open Access)
    AUTh Library subscriptions: ProQuest Central
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