Fecal microbiota transfer for bowel disorders: efficacy or hype?
Abstract
HighlightsFMT is use for recurrent, non‐responsive or fulminant colitis due to C. difficile.IBS and constipation (FC) are related to dysbiosis, thus FMT is suggested.Case series with FMT reported promising results in IBS and FC.RCT in IBS and FC with slow colonic transit have shown contradictory results.Well‐designed RCT, with IBS‐subgroups and microbiome analysis are warranted. &NA; Purpose of review: Dysbiosis has been related to the pathophysiology of disorders of – gut‐brain interaction (DGBI) including irritable bowel syndrome (IBS) and functional constipation (FC). Accordingly, modulation of gut microbiota has been proposed as a potential treatment for these disorders. Gut microbiota modulation can be effected by probiotics, prebiotics, symbiotics, postbiotics, antibiotics and fecal transplantation (FMT) or bacteriotherapy. The latter is currently used for recurrent or severe Clostridium difficile colitis and has been the focus of recent research in IBS and FC. Recent findings: Several case series reported promising results for FMT in patients with IBS and FC, which prompted the conduction of randomized controlled trials (RCT) in these DGBI. Summary: Both case series and RCTs are herein discussed. To the best of our knowledge, as of yet, 5 RCTs have been published on IBS and one in FC with slow colonic transit. In IBS, the majority of studies have used the IBS severity scoring system (IBS‐SSS) as an outcome measure; however, the selection criteria were different among…
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