Faecal matter transplant relieves bloating in IBS

Faecal microbiota transplantation (FMT) helps reduce abdominal bloating but not the overall symptoms in patients with irritable bowel syndrome (IBS), according to a small study.

A total of 56 patients with diarrhoea-predominant IBS were randomly assigned to FMT or placebo via the duodenal route at baseline and week 4. During the intervention, an infusion of 100-mL FMT solution containing 50-g donor stool or sham solution (100-mL normal saline) was administered into the distal duodenum via the duodenal route under conscious sedation.

The primary endpoint was a ≥50-point reduction in IBS severity scoring system (IBS-SSS) score at week 12. Secondary endpoints included improvement in bloating and change in gut microbiota at week 12. After 12-week follow-up, participants in the placebo group were assigned to receive open-label FMT.

Results showed no significant difference in the proportion of patients who achieved the primary endpoint: 57.1 percent in the FMT group and 46.4 percent in the placebo group (p=0.42). However, significantly more patients in the FMT group had an improvement in bloating (72 percent vs 30 percent; p=0.005).

In the open-label extension, 65.2 percent and 82.4 percent of the participants who initially received placebo achieved the primary endpoint and improvement in bloating, respectively, after FMT.

Looking at the faecal microbiome, a reduction in bacteria such as Ruminococcus gnavus and enrichment of bacteria such as Lawsonibacter were seen at week 12 in the FMT group. On the other hand, no significant change was observed in the placebo group. Functional analyses indicated that hydrogen sulphide-producing pathway was decreased in the FMT group (p<0.05), and this was accompanied by a reduction in contributing bacteria.

None of the participants in the FMT group experienced serious adverse events.