Fecal Microbiota Transplantation for IBS

tool for colonoscopy
Wicki58/E+/Getty Images

Fecal microbiota transplantation (FMT) is undergoing investigation as a viable treatment for a variety of health problems, most notably Clostridium difficile infection. FMT is a way to improve colonic health through the introduction of fecal matter that contains a wide variety of healthy gut bacteria. As more attention has been given to the role of gut bacteria in IBS, it seems natural to wonder if FMT would be an effective treatment for IBS. Let's take a look at what FMT is, how it works, and what research has uncovered regarding its usefulness for IBS.

What Is FMT?

FMT, also known as bacteriotherapy, is a procedure in which fecal matter from a healthy individual is transferred into the gastrointestinal tract of a person who is ill. Most of the time, this transfer occurs during a colonoscopy procedure, and less typically through the use of enemas. In rarer cases, the material may be transferred using a nasal tube that goes into the small intestine.

FMT has enjoyed increasing acceptance as a mainstream treatment option in large part because of its effectiveness in treating C diff, but also because scientists are increasingly focused on the role that gut dysbiosis plays in a large number of health problems. FMT is seen as superior to the use of antibiotics, prebiotics, and probiotics for improving gut health, due to the fact that healthy fecal matter contains a very wide variety of "friendly" strains of bacteria.

What FMT Can Treat

As mentioned above, FMT has become a primary treatment of C. diff, particularly in cases of re-occurrence. Scientific studies are being conducted to evaluate FMT as an effective treatment for:

What Is Involved

FMT cannot occur without donors. Individuals are screened to assure they are in good health. Donors offer stool samples which are then processed in preparation for the procedure. Typically fresh samples are used, although some research is being conducted on the efficacy of frozen material.

As discussed above, FMT can be conducted via colonoscopy, nasal tube, or enema. The colonoscopy option requires the same "prep" as a traditional colonoscopy, so as to clean out the colon.

Side effects of FMT are typically mild — short-term digestive symptoms — or non-existent. More serious outcomes are rare and occur at the same rate as any colonoscopy, nasal tube or enema procedure.

Because stool donor comes from another human, there are theoretical concerns about infections transmitted by donors to recipients via stool (like blood donations, before adequate screening was put into place). Doctors and researchers are developing screening policies and procedures to minimize this risk.

Can FMT Help IBS?

The idea of FMT for IBS is intriguing. Dysbiosis, an unhealthy state of gut microorganisms has been linked to the motility problems and visceral hypersensitivity that result in IBS symptoms. If FMT were to help to correct the dysbiosis, it would follow that patients would experience a lessening of symptoms.

Research on FMT for IBS is preliminary but promising. A small study involving only 13 patients who had not responded to traditional treatments for IBS, indicated that the procedure helped ease symptoms in just over two-thirds of participants — with improvement seen in the various symptoms that make up IBS. Another study has been published in which 45 patients with chronic constipation were treated with FMT and fecal enema infusions. A whopping 89% of participants reported an immediate lessening of constipation, bloating and abdominal pain. 30 patients reported back in 9 to 19 months after the procedure. Of these 30, 60% were experiencing normal bowel movements without having to use laxatives.

Bottom Line

At this point, it is way too early in the game to draw any conclusions about FMT becoming a viable treatment option for IBS. It will be interesting to see if future research supports early positive research findings. What would be important to ascertain is if the procedure is able to offer a clear advantage over other treatment options in order to make it worth its while and to confirm that it does not carry any significant short-term or long-term safety risks.

Was this page helpful?

Article Sources