Fecal microbiota transplantation. Prospects in pediatric practice

The aim of this review is to summarize data on the experience of using fecal microbiota transplantation (FMT) as a method of treating intestinal diseases, in particular in pediatric practice. FMT is the process of transferring fecal material from a healthy donor to the recipient’s gastrointestinal tract in order to alter gut microbial composition. To date, the most amount of research has been conducted in the field of treatment for Clostridium difficile infection. The mortality rate among children with this pathology is 1–5%. Randomized clinical trials show a higher efficacy of FMT compared to the use of antibiotics (efficacy rates of 90% and 26%, respectively) in the treatment for C. difficile infection. The effectiveness of FMT as a treatment for other diseases has been discussed. Cases of the successful use of FMT as a treatment for short bowel syndrome in children have been described, and studies on the effectiveness of this technique in patients with irritable bowel syndrome and inflammatory bowel diseases have been conducted. Most studies have been carried out on small samples of patients, and the results vary. The potential of using FMT as a treatment of children with severe bowel diseases is high, which makes it necessary to conduct further research in pediatric practice. Key words: inflammatory bowel disease, Clostridium difficile infection, short bowel syndrome, irritable bowel syndrome, fecal microbiota transplantation

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392 Post-Infectious Irritable Bowel Syndrome in Patients Undergoing Fecal Microbiota Transplantation for Recurrent Clostridium difficile Colitis

Gastroenterology ◽

10.1016/s0016-5085(14)60300-0 ◽

2014 ◽

Vol 146 (5) ◽

pp. S-83-S-84 ◽

Cited By ~ 1

Author(s):

Shashank Garg ◽

Yang Song ◽

Ma Ai Thanda Han ◽

Mohit Girotra ◽

W.F. Fricke ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Clostridium Difficile ◽

Fecal Microbiota Transplantation ◽

Fecal Microbiota ◽

Clostridium Difficile Colitis ◽

Irritable Bowel ◽

Post Infectious

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Fecal microbiota transplantation as a new therapy: from Clostridioides difficile infection to inflammatory bowel disease, irritable bowel syndrome, and colon cancer

Current Opinion in Pharmacology ◽

10.1016/j.coph.2019.04.017 ◽

2019 ◽

Vol 49 ◽

pp. 43-51 ◽

Cited By ~ 10

Author(s):

Thomas J Borody ◽

Guy D Eslick ◽

Robert L Clancy

Keyword(s):

Inflammatory Bowel Disease ◽

Colon Cancer ◽

Irritable Bowel Syndrome ◽

Bowel Disease ◽

Fecal Microbiota Transplantation ◽

Fecal Microbiota ◽

Clostridioides Difficile ◽

Clostridioides Difficile Infection ◽

Inflammatory Bowel ◽

Irritable Bowel

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Fecal Microbiota Transfer May Increase Irritable Bowel Syndrome and Inflammatory Bowel Diseases–Associated Bacteria

Gastroenterology ◽

10.1053/j.gastro.2012.12.040 ◽

2013 ◽

Vol 144 (4) ◽

pp. e19-e20 ◽

Cited By ~ 11

Author(s):

Sergey R. Konstantinov ◽

Maikel P. Peppelenbosch

Keyword(s):

Irritable Bowel Syndrome ◽

Inflammatory Bowel Diseases ◽

Fecal Microbiota ◽

Associated Bacteria ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Irritable Bowel

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Small and Large Intestine (II): Inflammatory Bowel Disease, Short Bowel Syndrome, and Malignant Tumors of the Digestive Tract

Nutrients ◽

10.3390/nu13072325 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2325

Author(s):

Yolanda Ber ◽

Santiago García-Lopez ◽

Carla J. Gargallo-Puyuelo ◽

Fernando Gomollón

Keyword(s):

Inflammatory Bowel Disease ◽

Short Bowel Syndrome ◽

Large Intestine ◽

Malignant Tumors ◽

Short Bowel ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Macro And Micronutrients ◽

Enteral And Parenteral Nutrition ◽

Small And Large Intestine

The small intestine is key in the digestion and absorption of macro and micronutrients. The large intestine is essential for the absorption of water, to allow adequate defecation, and to harbor intestinal microbiota, for which their nutritional role is as important as it is unknown. This article will describe the causes and consequences of malnutrition in patients with inflammatory bowel diseases, the importance of screening and replacement of micronutrient deficits, and the main indications for enteral and parenteral nutrition in these patients. We will also discuss the causes of short bowel syndrome, a complex entity due to anatomical or functional loss of part of the small bowel, which can cause insufficient absorption of liquid, electrolytes, and nutrients and lead to complex management. Finally, we will review the causes, consequences, and management of malnutrition in patients with malignant and benign digestive tumors, including neuroendocrine tumors (present not only in the intestine but also in the pancreas).

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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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FECAL CALPROTECTIN: levels for the ethiological diagnosis in Brazilian patients with gastrointestinal symptoms

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000100011 ◽

2015 ◽

Vol 52 (1) ◽

pp. 50-54 ◽

Cited By ~ 8

Author(s):

Lorete Maria da Silva KOTZE ◽

Renato Mitsunori NISIHARA ◽

Sandra Beatriz MARION ◽

Murilo Franco CAVASSANI ◽

Paulo Gustavo KOTZE

Keyword(s):

Ulcerative Colitis ◽

Irritable Bowel Syndrome ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Inflammatory Bowel Diseases ◽

Fecal Calprotectin ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Irritable Bowel ◽

Active Disease

Background Determination of fecal calprotectin can provide an important guidance for the physician, also in primary care, in the differential diagnosis of gastrointestinal disorders, meanly between inflammatory bowel diseases and irritable bowel syndrome. Objectives The aims of the present study were to prospectively investigate, in Brazilian adults with gastrointestinal complaints, the value of fecal calprotectin as a biomarker for the differential diagnosis between functional and organic disorders and to correlate the concentrations with the activity of inflammatory bowel diseases. Methods The study included consecutive patients who had gastrointestinal complaints in which the measurement levels of fecal calprotectin were recommended. Fecal calprotectin was measured using a Bühlmann (Basel, Switzerland) ELISA kit Results A total of 279 patients were included in the study, with median age of 39 years (range, 18 to 78 years). After clinical and laboratorial evaluation and considering the final diagnosis, patients were allocated into the following groups: a) Irritable Bowel Syndrome: 154 patients (102 female and 52 male subjects). b) Inflammatory Bowel Diseases group: 112 patients; 73 with Crohn’s disease; 38 female and 35 male patients; 52.1% (38/73) presented active disease, and 47.9% (35/73) had disease in remission and 39 patients with ulcerative colitis;19 female and 20 male patients; 48.7% (19/39) classified with active disease and 49.3% (20/39) with disease in remission. A significant difference (P<0.001) was observed between the median value of fecal calprotectin in Irritable Bowel Syndrome group that was 50.5 µg/g (IQR=16 - 294 µg/g); 405 µg/g (IQR=29 - 1980 µg/g) in Crohn’s disease patients and 457 µg/g (IQR=25 - 1430 µg/g) in ulcerative colitis patients. No difference was observed between the values found in the patients with Crohn’s disease and ulcerative colitis. Levels of fecal calprotectin were significantly lower in patients with inflammatory bowel diseases in remission when compared with active disease (P<0.001). Conclusions The present study showed that the determination of fecal calprotectin assists to differentiate between active and inactive inflammatory bowel diseases and between inflammatory bowel diseases and irritable bowel syndrome.

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