Research Progress in Fecal Microbiota Transplantation as Treatment for Irritable Bowel Syndrome

Irritable bowel syndrome is a functional disorder characterized by abdominal pain or discomfort associated with altered bowel habits. Due to the uncertainty of the pathogenesis of IBS and the diversity of its clinical manifestations, IBS cannot be completely cured. Increasing evidence suggests the key role of altered intestinal microbiota in the pathogenesis of IBS. Therefore, attention is being shifted to adjusting the changes in intestinal microbiota to control IBS symptoms. Fecal microbiota transplantation (FMT), antibiotics, probiotics, and synbiotics are currently often employed as treatment for IBS. And FMT is the most significant therapeutic efficacy with the least number of side effects. FMT provides a creative way to restore the abnormal gut microbiome in patients with IBS. But although current clinical studies confirm the effectiveness of FMT in the treatment of IBS, they are short-term studies of small samples, and there is still a lack of large-scale long-term studies. In this paper, we review the intestinal microbiota changes of IBS, the common methods of treating IBS with intestinal microbes, and the research status of FMT for the treatment of IBS. Finally, we put forward some opinions on the future research direction of FMT treatment of IBS.

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Gut Microbiota-Bile Acid Crosstalk in Diarrhea-Irritable Bowel Syndrome

BioMed Research International ◽

10.1155/2020/3828249 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16

Author(s):

Kai Zhan ◽

Huan Zheng ◽

Jianqing Li ◽

Haomeng Wu ◽

Shumin Qin ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Bile Acid ◽

Gut Microbiota ◽

Fecal Microbiota Transplantation ◽

Gastrointestinal Diseases ◽

Fecal Microbiota ◽

Farnesoid X Receptor ◽

Research Progress ◽

Functional Connections ◽

Irritable Bowel

The occurrence of diarrhea-predominant irritable bowel syndrome (IBS-D) is the result of multiple factors, and its pathogenesis has not yet been clarified. Emerging evidence indicates abnormal changes in gut microbiota and bile acid (BA) metabolism have a close relationship with IBS-D. Gut microbiota is involved in the secondary BA production via deconjugation, 7α-dehydroxylation, oxidation, epimerization, desulfation, and esterification reactions respectively. Changes in the composition and quantity of gut microbiota have an important impact on the metabolism of BAs, which can lead to the occurrence of gastrointestinal diseases. BAs, synthesized in the hepatocytes, play an important role in maintaining the homeostasis of gut microbiota and the balance of glucose and lipid metabolism. In consideration of the complex biological functional connections among gut microbiota, BAs, and IBS-D, it is urgent to review the latest research progress in this field. In this review, we summarized the alterations of gut microbiota in IBS-D and discussed the mechanistic connections between gut microbiota and BA metabolism in IBS-D, which may be involved in activating two important bile acid receptors, G-protein coupled bile acid receptor 1 (TGR5) and farnesoid X receptor (FXR). We also highlight the strategies of prevention and treatment of IBS-D via regulating gut microbiota-bile acid axis, including probiotics, fecal microbiota transplantation (FMT), cholestyramine, and the cutting-edge technology about bacteria genetic engineering.

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Engraftment of strictly anaerobic oxygen-sensitive bacteria in irritable bowel syndrome patients following fecal microbiota transplantation does not improve symptoms

Gut Microbes ◽

10.1080/19490976.2021.1927635 ◽

2021 ◽

Vol 13 (1) ◽

pp. 1-16

Author(s):

Patrick Denis Browne ◽

Frederik Cold ◽

Andreas Munk Petersen ◽

Sofie Ingdam Halkjær ◽

Alice Højer Christensen ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Fecal Microbiota Transplantation ◽

Fecal Microbiota ◽

Strictly Anaerobic ◽

Oxygen Sensitive ◽

Irritable Bowel

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Irritable bowel syndrome and transplantation of fecal microbiota. Review

Modern Gastroenterology ◽

10.30978/mg-2021-4-45 ◽

2021 ◽

Author(s):

G. D. Fadieienko ◽

O. Y. Gridnyev

Keyword(s):

Irritable Bowel Syndrome ◽

Fecal Microbiota Transplantation ◽

Positive Outcome ◽

Fecal Microbiota ◽

Cochrane Library ◽

Placebo Control ◽

Global Improvement ◽

Recurrent Clostridium Difficile Infection ◽

Significant Difference ◽

Irritable Bowel

Objective — to perform analysis of the literature data as regards the efficacy of the use of fecal microbiota transplantation (FMT) in patients with the irritable bowel syndrome (IBS). Materials and methods. The systematic review of the literature (PubMed, MEDLINE, Cochrane Library) has been performed to assess the results of investigation on the use of FMT in adult IBS patients. Results. Currently, FMT is a safe and highly successful method of treatment for recurrent Clostridium difficile infection, and possibility to use FMT in the treatment of other diseases is under investigation. The results of FMT treatment of patients with IBS are contradictory. A number of authors outline fairly high FMT efficacy when used for the treatment of patients with IBS, refractory to the standard methods: it varies from 36 % to 70 % with a duration of adequate symptoms’ relief up to 1 year. However, other authors indicate that the positive FMT clinical effect lasted from 8 weeks to 3 months, after which there was a gradual recovery of symptoms. At the same time, the researchers noted that mostly often the positive outcome was reached after FMT from donors with a higher number of streptococci in the feces. Still others point out that there was no sustained, at least 50‑point reduction in the severity of IBS symptoms from baseline. Some authors did not reveal the advantages of FMT over placebo control and even reported about the higher placebo efficacy. After data generalization no significant difference was revealed in the global improvement in IBS symptoms in patients receiving donor FM versus placebo. However, the attention is drawn to the relationship between the results of FMT with methodology. Indeed, several studies have shown that placebo capsules were more effective than capsules containing donor feces, whereas FMT from donor stool delivered by colonoscopy was superior to FMF from autologous stool. This may be due to the excipients, containing in the capsulated FMT. A number of researchers also indicated that the use of a super donor is necessary for successful FMT and that the response to FMT is dose dependent. Conclusions. To resolve the issue of the expediency of using FMT in routine clinical practice in patients with IBS, more qualitative controlled studies, involving large cohorts of IBS patients and long‑term follow‑up, are required.

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