Fecal transplantation improves the gut of IBS patients

Transplantation of feces from a healthy person to a patient suffering of irritable bowel syndrome (IBS) improved both symptoms of IBS and the gut's bacteria profile.

Irritable bowel syndrome (IBS) is a common disease, which may cause symptoms like stomachaches, excessive gas, bloating, diarrhea and constipation. The symptoms disables the patient, but unlike other stomach diseases like Crohn's, ulcerative colitis or celiac disease, the doctors do not know what causes the disease.

Nutrition researchers are now investigating ways to reduce the symptoms of IBS. Many patients benefit greatly from following a low FODMAP-diet, a diet low of certain carbohydrates that are poorly absorbed in the intestine, like garlic, lenses or apples. As there is no known "cure" for IBS, the researchers are also investigating whether transplantation of feces, what the researchers call "fecal transplantation", from a healthy person to a patient with IBS, could improve the daily life of these patients.

The research in this field is still quite new, and at the Department of Clinical Sciences at the University of Bergen, the researchers are the first ones to investigate whether fecal transplantation not only reduces the symptoms of IBS, but also has the power to change the patient's gut microbiota.

"Earlier studies was limited to investigating effect on symptoms, but we also wanted to see whether the transplantation could significantly change the patients microbiota, explains Gülen Arslan Lied, professor at the Centre for Nutrition, University of Bergen.

Seventy percent of the patients experienced reduced symptoms

In this study, they transplanted feces from one healthy donor, a family member of the patient, and placed it in the belly of the patient through gastroscopy. In gastroscopy, they place a tube into the throat of the patient and into the belly. The study included 13 IBS patients, which has a variant of IBS that mainly causes diarrhea.

The researchers measured the microbiota before the treatment. The patients evaluated their symptoms through a questionnaire, on the day of treatment, one week, twelve week and 28 weeks after the transplantation. The researchers measured the microbiota of the feces of the patients and the donors, at the same time intervals.

"We found that 70 percent of the patients experienced relieved symptoms, and a better quality of life, three months after the treatment," Lied says.

28 weeks after the treatment, the effect on the symptoms had decreased. However, when they compared the gut microbiota of the patients with the healthy subjects, they found that the gut microbiota of the patients had significantly changed, and were a lot more similar to that of the donors.

Replacing bad bacteria with the good ones

According to Lied, the gut microbiota plays a big role in how we feel.

"The ratio between the different bacteria in our stomach and intestine produces various metabolites, which gives symptoms as those in IBS. Our findings indicate that it may be possible to reestablish a healthy microbiota in those suffering from IBS."

However, Lied underlines the need of more research on this subject, before one can draw conclusions. For instance, the study has only looked on the effect this type of treatment has on one type of IBS patients, namely those suffering of diarrhea. The reason for is that, this type of treatment has proven beneficial for people suffering from the disease Clostridum difficile enterecolitis, which also has diarrhea as its main symptom.

More research to come

Secondly, the study the performed was quite small, and there were no control groups, making it hard for the researchers to eliminate the placebo effect.

"The change in the gut microbiota is however objective findings," Lied underlines.

The researchers are now finishing a big, randomized control study. In this study, the patients receive one of three treatments of fecal transplantation, where one of them are placebo. They also have another study coming up, funded and supported by the Norwegian Research Council.

"We are curious to see how the microbiota of the gut affects the brain," Lied says.​

Source: https://www.uib.no/en

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