Abstract
BackgroundShort‐chain fatty acids (SCFAs) may play a role in the pathophysiology of irritable bowel syndrome (IBS). This study analyzed fecal SCFAs after performing fecal microbiota transplantation (FMT) in the IBS patients who were included in our previous study of the efficacy of FMT.MethodsThis study included 142 of the 164 IBS patients who participated in our previous study. They were belonging to three groups: placebo (own feces), 30‐g (superdonor feces), and 60‐g (superdonor feces) FMT. The patients completed the IBS Severity Scoring System (IBS‐SSS) Birmingham IBS Symptom, Fatigue Assessment Scale (FAS), the IBS Quality of Life (IBS‐QoL) and Short‐Form Nepean Dyspepsia Index (SF‐NDI) questionnaires and delivered fecal samples at the baseline and 1 month after FMT. The SCFA levels were determined by vacuum distillation followed by gas chromatography.Key ResultsThe fecal butyric acid level was significantly increased after FMT in both the 30‐g and 60‐g groups (both P ≤ 0.001). In the 60‐g group, the levels of total SCFAs and isobutyric, isovaleric, and valeric acids increased after FMT. Butyric acid levels in the responders in both the 30‐g and 60‐g FMT groups were significantly inversely correlated with IBS‐SSS and FAS scores (P = 0.001, r = −0.3 and P = 0.0001. r=‐ 0.3, respectively). There were no differences in the SCFA levels in the placebo group after FMT.Conclusion and InferencesFMT increases the fecal SCFA levels in IBS patients. The increase in the butyric acid level is inversely correlated with symptoms in IBS patients following FMT, suggesting that SCFAs might play a role in the pathophysiology of IBS. www.clinicaltrials.gov (NCT03822299).
Highlights
The intestinal bacterial profile in patients with irritable bowel syndrome (IBS) differs from that in healthy subjects.[2]
These changes varied with the transplant dose, while the alterations in the short-chain fatty acid (SCFA) levels in response to fecal microbiota transplantation (FMT) differed with the IBS subtype
In the 60-g group, the fecal levels of total SCFAs, isobutyric, isovaleric, and valeric acids increased in the responders following FMT
Summary
The intestinal bacterial profile in patients with irritable bowel syndrome (IBS) differs from that in healthy subjects.[2]. Short-chain fatty acids (SCFAs) are the main products of bacterial fermentation of undigested and unabsorbed carbohydrates in the intestine.[3] SCFAs are the main energy source for colonic epithelial cells, regulating gut barrier functions and local immune defenses.[3] Among the SCFAs, butyric acid has anti-inflammatory and intestinal regenerative effects and administration of sodium butyrate to patients with inflammatory bowel disease changes the gut bacterial composition and induce the growth of butyric acid-producing bacterial genera.[3]. The fecal SCFA levels differ between IBS patients and healthy subjects, with the fecal propionic acid level being significantly higher in IBS patients.[3] Whereas the levels of propionic and butyric acids were lower in constipation-predominant IBS (IBS-C) patients than in healthy subjects, that of butyric acid in diarrhea-predominant IBS (IBS-D) patients was higher.[3]. The present study investigated whether FMT caused alterations in the fecal SCFAs in the same cohort of patients that we investigated in our previous study
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