Irritable bowel syndrome can be eased for at least three years by faecal transplants, according to the longest-running clinical trial so far.
About 10 per cent of the global population have IBS, typically experiencing symptoms including chronic gut pain, fatigue, bloating, constipation and diarrhoea. Some medications can reduce the symptoms but don’t address the root cause.
Studies have found that people with IBS often have an imbalance of “good” and “bad” gut microbes, hinting that it may be possible to treat their condition by recolonising their guts with a healthier mix of microbes.
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To test this idea, Magdy El-Salhy at Stord Hospital in Norway and his colleagues collected faeces from a 36-year-old man judged to have an optimum mix of gut microbes.
They transferred samples of his stool mixed with water into the small intestines of 87 patients with moderate-to-severe IBS in order to introduce his mix of gut microbes. Another 38 patients had samples of their own faeces transferred to their small intestines as a placebo. None of the participants knew which kind of faeces they had been given.
Three years later, at least 64 per cent of the participants who received the healthy stool transplant had fewer gut symptoms, less fatigue and better quality of life. In contrast, only 27 per cent of the placebo group reported improvements.
Other clinical trials have demonstrated that faecal transplants are safe and effective in treating IBS, but they haven’t monitored participants for so long.
“It’s certainly promising,” says at Flinders University in Adelaide, Australia. “For many people, the idea of having someone else’s faecal material put inside them might seem off-putting, but people with IBS have often been suffering for years or even decades and they’re desperate for anything that works.”
At the moment, it isn’t feasible to offer faecal transplants to all people with IBS because of the cost, but, in future, we may be able to isolate “good” microbes from healthy donors’ stools and administer them in tablet form, says Brierley.
“This trial shows that we can reverse the disease process of IBS just by changing what’s in the gut,” he says.
Gastroenterology
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