A fecal transplant could ease the painful and disturbed symptoms of a funny bowel syndrome – if those transplants come from people called “super donors,” according to studies that were presented on Sunday.
The large double-blind placebo controlled test – the gold standard for medical research – considered that micro-transplant improved fecal symptoms of IBS in almost half of patients. Principal researcher Magdy El-Salhy, professor in the department of clinical medicine at the University of Bergen in Norway, presented the study at United European Gastroenterology Week in Spain.
IBS is estimated to be between 10 and 15 percent of Americans, according to American College of Gastroenterology. Symptoms include abdominal cramping and bloating as well as bite and diarrhea. Although the condition can cause significant pain and discomfort, it does not damage the intestine.
The reason for IBS is unknown, but some researchers have indicated that it may be linked to abnormal microbes, the abundance of micro-organisms that fill the gut.
Fecal transplantation, or fecal microbiota transplantation (FMT), working through a healthier set of remodeling micro-organisms. Stool from a donor is then processed and transplanted into the receiver's lock.
Investigated whether FMT could calm down the properties of IBS, El-Salhy and his colleagues recruited 164 patients who were diagnosed with the condition and who had moderately severe symptoms.
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Before treatment, patients were asked in detail about their symptoms. They were then randomly assigned to get 30 grams of solution containing their own feces – the placebo – or one of two doses (30g or 60g) containing feces from a so-called super donor. The doses were delivered to the small intestine through a tube inserted into the mouth and down the throat.
Three months later, patients were again asked to specify the symptoms. Compared to pre-treatment, 23.6 percent reported patients in the placebo group had a moderate improvement in symptoms. In the group received the lower dose super donor feces, 76.9 reported moderate response, and in the higher dose group, 89.1 percent.
Most importantly, they received a remission of signals – meaning that ministers completely disappeared – in 35.2 per cent of those in the lower dose group, and in 47.3 per cent of those in the higher dose group. This compares with 5.5 percent of patients in the placebo group who reported symptom remission.
A year later, El-Salhy said that the effects seem to have survived. “The preliminary results (suggesting) most, 90 to 95 percent, of patients who responded well still and about 50 percent are red cured, '” he wrote in an email .
Previous studies have also looked at the effects of FMT on IBS signals, and have mixed results. El-Salhy added credit to the effectiveness of the treatment in his study for the specific donor microbe.
“We had carefully selected a donor from a number of candidates who had characteristics that had a positive impact on intestinal microbes,” said El-Salhy. Overall, the donor was healthy, he was breastfeeding, he spent a nutritious diet, he did not take regular medications, he was not only a nonsmoker and he did not take antibiotics just a few times, he said.
The results placed great emphasis on experts, but they were a little suspicious about the idea of a super donor, because it was not clear how El-Salhy's results could be doubled.
“These are very promising results that will generate a lot of interest and attention as IBS is of great interest to these therapeutic types,” said Dr. Alexander Khoruts, professor of medicine and medical director of the Microbiota Therapeutic Program at the University of Minnesota. “But it's not clear how you can super find another donor to reproduce these results. ”
Dr. agreed. Jonathan Jacobs, assistant medical professor at the University of California, Los Angeles Medical School and director of UCLA's Microbiome Essence. If it happens that these results can only be made with a stool from a super donor, which may be rare, “then we wouldn't be better off,” he said.
In light of the mixed results in previous studies dealing with PPI with FMT, “I am not sure that this study will allow us to conclude that a super donor is needed, but that there is a need to validate FMT in general. further studies, ”said Dr.. t Purna Kashyap, associate professor of medicine, physiology and biomedical engineering and co-director of the Microbiology Program at the Mayo Clinic.
Indeed, it is not yet clear what role stomach bacteria play in IBS, and in fact, most studies show that micro-people of IBS are like a healthy micro, Kashyap wrote in email. With that in mind, “how do you decide what a good donor should be?” Kashyap added.
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