Long-term effects of fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome.

Abstract

We recently found fecal microbiota transplantation (FMT) in irritable bowel syndrome (IBS) patients to be an effective and safe treatment after 3months. The present follow-up study investigated the efficacy and safety of FMT at 1year after treatment. This study included 77 of the 91 IBS patients who had responded to FMT in our previous study. Patients provided a fecal sample and completed five questionnaires to assess their symptoms and quality of life at 1year after FMT. The dysbiosis index (DI) and fecal bacterial profile were analyzed using a 16S rRNA gene-based DNA probe hybridization. The levels of fecal short-chain fatty acids (SCFAs) were determined by gas chromatography. There was a persistent response to FMT at 1year after treatment in 32 (86.5%) and 35 (87.5%) patients who received 30-g and 60-g FMT, respectively. In the 30-g FMT group, 12 (32.4%) and 8 (21.6%) patients showed complete remission at 1year and 3months, respectively; the corresponding numbers in the 60-g FMT group were 18 (45%) and 11 (27.5%), respectively. Abdominal symptoms and the quality of life were improved at 1year compared with after 3months. These findings were accompanied by comprehensive changes in the fecal bacterial profile and SCFAs. Most of the IBS patients maintained a response at 1year after FMT. Moreover, the improvements in symptoms and quality of life increased over time. Changes in DI, fecal bacterial profile and SCFAs were more comprehensive at 1year than after 3months. www.clinicaltrials.gov (NCT03822299).