Irritable Bowel Syndrome Clinical Trial
Official title:
Fecal Microbiota Transplantation in Irritable Bowel Syndrome With Bloating: a Double Blind, Placebo Controlled Randomised Clinical Trial
Intestinal microbiota dysbiosis is thought to play an important role in the complex
pathophysiology of irritable bowel syndrome (IBS), especially in diarrhoea-predominant IBS
and possibly in IBS with severe bloating. Fecal microbiota transplantation or FMT has been
shown to be an effective means of correcting this imbalance in the gut microbiota, especially
in patients with recurrent Clostridium difficile infections where it has become a preferred
treatment strategy.
In a preliminary pilot study in 12 patients we found that FMT was a safe and accepted therapy
in IBS patients. In 75% of patients an amelioration of IBS symptoms in general and abdominal
bloating was seen three months after transplantation.
In this study the effects of FMT on patients with IBS without constipation and bloating will
be investigated in a double blind, placebo controlled RCT.
Intestinal microbiota dysbiosis is thought to play an important role in the complex
pathophysiology of irritable bowel syndrome (IBS), especially in diarrhoea-predominant IBS
and possibly in IBS with severe bloating. Fecal microbiota transplantation or FMT has been
shown to be an effective means of correcting this imbalance in the gut microbiota, especially
in patients with recurrent Clostridium difficile infections where it has become a preferred
treatment strategy.
In a preliminary pilot study in 12 patients we found that FMT was a safe and accepted therapy
in IBS patients. In 75% of patients an amelioration of IBS symptoms in general and abdominal
bloating was seen three months after transplantation.
In this study the effects of FMT on patients with IBS without constipation and bloating will
be investigated in a double blind, placebo controlled RCT. Donors for this study will be
recruited from a healthy donor pool who will donate stool after clearance of a strict
inclusion protocol which will assess the presence of any infectious diseases. Stool will be
frozen following the protocol described in Hamilton et al 2012. Patients will deliver a stool
portion that will be frozen as well.
At time of FMT, patients will be randomised in a double blinded fashion to the treatment arm
(healthy donor stool) or placebo arm (own stool). Transplantation will be preformed by means
of a colonoscopy with deliverance in the right colon and ileum.
Following FMT patients will be followed clinically with questionnaires and regular visits to
the clinic. Stool samples will be collected on a regular basis for microbiome analysis.
At the end of the study, patients from the placebo-group will be given the opportunity to be
transplanted with healthy donor stool if necessary. Follow-up will continu for a total
duration of one year.
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