Irritable Bowel Syndrome Message Boards | Fecal Microbiota Transplant Relieves IBS With Predominant Bloating

JULY 25, 2018

Gastroenterology & Endoscopy News

Fecal Microbiota Transplant Relieves IBS With Predominant Bloating

Washington�Fecal microbiota transplant is an effective treatment for symptoms of irritable bowel syndrome with predominant abdominal bloating, according to results of a double-blind trial.

Nearly half of the patients treated with FMT reached the primary end point of adequate symptom relief 12 weeks after treatment versus 29% of those treated with placebo. In addition, FMT patients had statistically significant reductions from baseline in discomfort, number of stools, urgency, flatulence and abdominal pain, reported Tom Holvoet, MD, PhD, a researcher in the Department of Gastroenterology at the University Hospital in Ghent, Belgium. These benefits were not seen in controls, according to Dr. Holvoet, who presented the data at the 2018 Digestive Disease Week (abstract 617).

For enrollment in this study, patients were required to have IBS with predominant abdominal bloating, as defined in the ROME III criteria. Patients with constipation were excluded. Sixty-four eligible patients were randomly assigned in a 2:1 ratio to receive FMT with fresh donor stool or a control of the patient's own stool. The active treatment stool provided from two donors had been associated with benefit against IBS in a previous pilot study. This stool also was characterized as having "high microbial richness." The investigators collected stool samples at baseline, at intervals during the study, and at the end of 12 weeks to examine changes in gut microbiota, according to Dr. Holvoet.

At the end of 12 weeks, 49% of patients in the experimental group reported adequate relief of both general IBS symptoms and abdominal bloating. This rate of response was nearly 70% higher than the 29% rate of adequate relief in the control group (P=0.004). Among specific symptoms, the 26% reduction from baseline in abdominal pain (P=0.001) and the 19% reduction in general discomfort (P=0.001) were highly statistically significant, Dr. Holvoet noted.

The investigators are conducting ongoing analyses, noting that linking IBS symptoms with specific bacterial species could provide new opportunities for more targeted FMT as well as treatment with probiotics.

Although advances in understanding the importance of gut microflora in human diseases has led many to speculate that dysbiosis may be a factor in IBS and other functional bowel disorders, this is one of the first well-controlled randomized trials with FMT, Dr. Holvoet said. Several recently published reviews, such as one by investigators at Beth Israel Deaconess Medical Center, in Boston (Ann Transl Med 2017;5[24]:506), have found a growing body of evidence of benefit from FMT in uncontrolled studies as well as experimental evidence supporting the concept.

"FMT is allowing us to understand the microbial contribution of several chronic diseases," said Jessica R. Allegretti, MD, the director of clinical trials at the Crohn's and Colitis Center at Brigham and Women's Hospital, in Boston. An investigator who has participated in several studies with FMT and who recently wrote a review of the role of FMT in inflammatory bowel diseases (Inflamm Bowel Dis 2017;23[10]:1710-1717), Dr. Allegretti called these data "very encouraging, given that bloating is one of the most difficult symptoms to treat" in patients with IBS.

�Ted Bosworth

https://www.gastroendonews.com/In-the-News/Article/07-18/Fecal-Microbiota-Transplant-Relieves-IBS-With-Predominant-Bloating/50110

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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

Edited by Heather (07/25/18 12:50 PM)

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