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Fecal transplant improves refractory IBS with abdominal bloating

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WASHINGTON — Fecal microbiota transplantation improved symptoms in patients with refractory irritable bowel syndrome with severe abdominal bloating, according to research presented here.

“This is one of the first ... randomized controlled trials looking into fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome and predominant abdominal bloating, and our results suggest that this is a very effective treatment for these patients,” Tom Holvoet, MD, of Ghent University Hospital in Belgium, said during his presentation.

Between December 2015 and September 2017, Holvoet and colleagues randomly assigned 43 patients with refractory IBS symptoms and predominant abdominal bloating to undergo FMT via nasojejunal tube using fresh stool from two selected donors, and 19 to undergo FMT using their own frozen stool as placebo. Self-reported symptom improvement at 12 weeks served as the primary endpoint.

Among those who received FMT, 49% reported they experienced adequate relief of general IBS symptoms and abdominal bloating vs. 29% among those who received placebo (P = .004). Further, FMT patients reported significant improvements in discomfort (mean reduction, 19%; P = .001), reduced number of stools (mean reduction, 13%; P = .02), reduced urgency (mean reduction, 38%; P = .01), less abdominal pain (mean reduction, 26%; P = .001) and reduced flatulence (mean reduction, 10%; P = .04), while the placebo group did not. IBS-related quality of life also improved in the FMT group (16% improvement; P = .03).

Among 22 responders who were contacted at 1 year, six (27%) reported long-lasting effects, and five of them had been randomized to the FMT group.

Preliminary microbiota analysis of stool samples showed FMT induced significant changes to microbial composition, and these appeared to influence therapeutic success, Holvoet noted. – by Adam Leitenberger

Reference:

Holvoet T, et al. Abstract 617. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosures: Holvoet reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.