Frontier
Copyright ©The Author(s) 2021.
World J Gastroenterol. Jun 14, 2021; 27(22): 2921-2943
Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.2921
Table 1 Summary of seven randomized controlled trials of fecal microbiota transplantation for irritable bowel syndrome
Study
IBS subtypes
Number of patients (% female)
Intervention (number of patients)
Route of administration
Primary endpoint
Results
Microbiota assessment
Johnsen et al[22], 201853.0% IBS-D, 47.0% IBS-M83 (66.3%)50-80 g of single FMT (2 donors) (55) vs autologous stool (28)Colon via a colonoscopeDecrease in IBS severity scoring system of ≥ 75 points at 12 wk and 12 moResponse rate: 12-wk FMT 65% vs placebo 43% (P < 0.05); 12-mo 56% in FMT vs placebo 36% (P > 0.05)Unkown
Halkjær et al[23], 201837.3% IBS-M, 33.3% IBS-C, 29.4% IBS-D52 (68.6)50 g ofdonor stool per dayfor 12 d (4 donors) (26) vs placebo capsules (26)Oral capsulesDecrease in IBS severity scoring system of ≥ 50 points at 12 wkResponse rate: FMT 36.4% vs placebo 79.2%, P < 0.05FMT increased microbiota biodiversity shift to the donor
Aroniadis et al[24], 2019100% IBS-D24 (37.5) Crossover after 12 wk9.5 g of donor stool per day for 3 d (4 donors involved but each participant received from 1 donor) (24) vs placebo capsules (24)Oral capsulesDecrease in IBS severity scoring system of ≥ 50 points at 12 wkFMT-first 50% vs placebo-first 61%, (P = 0.46)Prevotella abundance did not change after FMT; Similar diversity between responders and non-responders
Holster et al[25], 201956% IBS-D, 25.0% IBS-C, 19% IBS-M with a low amount of butyrate producing bacteria in their fecal samples17 (50.0%)30 g of single FMT (1 donor) (8) vs autologous stool (8)Colon via a colonoscopeDecrease in gastrointestinal symptom rating scale-IBS of ≥ 30%Symptom and QoL improved from baseline only in FMT arm (P < 0.05) but not different between armsTrend of fecal and mucosal microbiota shift to the donor. No significant change in diversity and butyrate-producing bacteria
Lahtinen et al[26], 202051% IBS-D, 28.6% IBS-U. 14% IBS-M, 6% in remission49 (59.2%)30 g of single FMT (1 donor) (23) vs 30 g of autologous stool (26)Colon via a colonoscopedecline in the IBS-SSS score of ≥ 50 points throughout 52 wkPrimary endpoint was not achieved in both arms. Only transient improved in FMT arm vs baseline at week 12 Significant shift in the microbiota profile and richness increased in FMT group
El-Salhy et al[11], 202038.4% IBS-D, 37.8% IBS-C, 23.8% IBS-M164 (81%)single 30 g FMT (54) vs 60 g (55) vs autologous stool (55)Distal duodenum via a gastroscopetotal IBS-SSS score decreased by ≥ 50 points at 3 moResponse rate: 30 g FMT 76.9%, 60 g FMT 89.1%, control 23.6% P < 0.05; response independent of gender, IBS subtypeAt 1 mo: Dysbiosis index/prevalence were not different at baseline vs post FMT (P > 0.05), Responder had higher signals forEubacterium biforme, Lactobacillus spp. and Alistipes spp. After FMT, and lower signals for Bacteroides spp
Holvoet et al[27], 2021100% IBS-D or IBS-M with predominant bloating62 (64.7)Single FMT (2 male donors, each participant received from 1 donor) (43) vs autologous stool (19)Small intestine via a nasojejunal tubeSelf-reported adequate relief of symptoms at 12 wk and 1 yrResponse rate: FMT 56% vs control 26% (P < 0.05); Good response predictor: women (69% vs 29%), patients with high baseline diversity, distinct composition (P < 0.05) 1 yr response FMT 21% vs control 6%; Second FMT restored response in 67% of patients with prior responseUnknown