FMT study shows efficacy in treating Irritable Bowel Syndrome
Fecal Microbiota Transplantation for
Irritable Bowel Syndrome
by Steven Sandberg-Lewis, ND, DHANP
A new study published June 2022 in Gastroenterology, a major medical journal, attempts to answer the question “Does FMT benefit people suffering from IBS?” Up until now, no one has known how to answer this. This study proves significant benefit which persisted for up to three years after transplant.
Fecal microbiota transplantation allows for the transfer of one person’s beneficial colonic microbiome to a recipient patient. It involves the introduction of donor liquified stool via enema, colonoscopy, or endoscope. Some practitioners have also used triple encapsulated oral methods. The stool comes from a donor who has no digestive problems or communicable diseases. The donor is tested for viral hepatitis and other infectious diseases prior to donation of stool.
FMT has been shown to be very effective for treating Clostridium difficile (C. difficile) diarrhea as well as ulcerative colitis but is FDA approved only for C. difficile diarrhea.
In this study, the subjects all had irritable bowel syndrome of either the diarrhea type (IBS-D), constipation type (IBS-C) or a mix of the two (IBS-M). They filled out questionnaires describing quality of life measures and had their stools analyzed for over 300 bacteria to determine the level of dysbiosis for each subject.
The study structure: Stool from healthy donors was immediately frozen and wasn’t thawed until two days prior to the procedure to instill it in the upper small intestine of the IBS subjects. This was done using an endoscope. The patients were randomly divided into three groups. The first received 30 grams of their own feces, becoming the “placebo” group. The other two groups received either 30 or 60 grams of donor feces.
The quality-of-life scores in those who received the 30 and 60 grams of donated samples (FMT) were significantly improved (69.1% for 30 grams and 77.8% for 60 grams) compared to those in the placebo group (only 26.3% improved). The benefits held at a very high rate for both two and three years after FMT. The improvements included decrease or elimination of abdominal pain, abdominal distension, bowel-habits dissatisfaction, fatigue, and quality-of-life interference. There was no long-term or serious adverse effect.
Increases in beneficial bacteria were found for Alistipes, Bacteroides, Prevotella, Parabacteroides johnsonii, Firmicutes, Eubacterium biforme, and Faecalibacterium prausnitzii in both treatment groups but not the placebo group. These positive changes persisted for up to 3 years.
Source:
El-Salhy M, Winkel R, Casen C, Hausken T, et al. Efficacy of Fecal Microbiota Transplantation for Patients With Irritable Bowel Syndrome at 3 Years After Transplantation. Gastroenterology. 2022 Jun 13:S0016-5085(22)00625-4. PMID: 35709830
Steven Sandberg-Lewis, ND, has been in clinical practice for 44 years, with a focus on functional gastroenterology. He has been a professor since 1985, teaching a variety of courses but primarily focusing on gastroenterology and GI physical medicine. In 2019, Dr. Sandberg-Lewis co-founded Hive Mind Medicine, continuing his specialization in gastroenterology with a focus on reflux, SIBO, inflammatory bowel disease and functional GI disorders.
He is currently working on his latest book, Let's Be Real About Reflux: Getting to the Heart of Heartburn, written to help non-medical and medical professionals alike develop a better understanding of reflux and options for its natural treatment.