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Treatment of Slow Transit Constipation With Fecal Microbiota Transplantation: A Pilot Study

Tian, Hongliang PhD; Ding, Chao MD; Gong, Jianfeng PhD; Ge, Xiaolong MD; McFarland, Lynne V. PhD; Gu, Lili PhD; Wei, Yao PhD; Chen, Qiyi PhD; Zhu, Weiming PhD; Li, Jieshou PhD; Li, Ning PhD

doi: 10.1097/MCG.0000000000000472
ALIMENTARY TRACT: Original Articles

Background: Fecal microbiota transplantation (FMT) has been proposed as a therapeutic approach for functional gastrointestinal disease. We launched a clinical study to examine the safety and efficacy of FMT for slow transit constipation (STC).

Materials and Methods: Twenty-four patients with STC, aged from 20 to 74 were enrolled in this prospective open-label study. Patients received FMT on 3 consecutive days through nasojejunal tubes and followed up for 12 weeks after treatment. Rate of clinical improvement and remission, Wexner constipation scale, Bowel movement per week, and gastrointestinal quality-of-life index were evaluated.

Results: The rate of clinical improvement and remission based on clinical activity at week 12 was 50% (12/24) and 37.5% (9/24), respectively. The patient’s stool frequency increased from a mean of 1.8 (SD 1.3) per week pre-FMT to 4.1 (SD 2.6) at week 12 post-FMT without laxative usage (P<0.01). The stool consistency showed a tendency to improve after FMT administration. Comparison of pre-FMT and post-FMT Wexner constipation scores demonstrated a significant reduction between baseline (14.1±3.3) and the first week (9.8±4.9), which was maintained up to the following 12 weeks (7.5±3.2; P<0.01). Compared with baseline, significant overall improvements were also seen in gastrointestinal quality-of-life index score at week 1, week 2, week 4, week 8, and week 12 of follow-up (P<0.01). The improvements were accompanied by the decline of colonic transit time. No severe adverse events during the whole FMT procedure follow-up except for venting (6/24), abdominal pain (3/24), bloating (2/24), and diarrhea (7/24).

Conclusion: This is a pilot study demonstrating that FMT was safe and may have the potential to improve symptoms in patients with STC.

*Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China

Department of Medicinal Chemistry, University of Washington, Seattle, WA

H.T. and C.D. contributed equally.

Supported by Jiangsu Province Special Program of Medical Science (BL2012006) and Jiangsu Province Postgraduate Student Research Innovation Projects (No.KYLX15_0046).

The authors declare that they have nothing to disclose.

Address correspondence to: Ning Li, PhD, Jinling Hospital, Research Institute of General Surgery, Nanjing University School of Medicine, No. 305 East Zhongshan Road, Nanjing 210002, China (e-mail: liningrigsnju@163.com). and Jianfeng Gong, PhD, Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing 210002, China (e-mail: gongjianfeng@aliyun.com).

Received August 15, 2015

Accepted November 24, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.