Fecal Transplants for IBS
Irritable bowel syndrome (IBS) is a widespread, chronic gastrointestinal disorder that affects up to 20% of both teenage and adult populations. It is grouped into three categories: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D) and mixed IBS (IBS-M). It causes irregular bowel routines, abdominal pain, altered stool consistencies and constipation, mucus in stools, and bloating. All of these symptoms lead to a diminished quality of life. This is why a fecal transplant for IBS may be considered.
For years, creating an effective treatment for this condition has been hindered by limited knowledge of the cause of the disease. Historically, the biological mechanism progress of IBS has been based on the brain-gut axis where the sensitivity to IBS symptoms is altered by stress and other psychological conditions. Growing evidence shows that peripheral mechanisms in the intestine such as unusual immune activation, low-grade mucosal inflammation and adjusted visceral sensitivity could be the key drivers of the symptoms of IBS, at least in a subgroup of IBS patients.
Emerging data indicates that the intestinal microbiota is a fundamental part of the IBS pathophysiology. This comes from an early observation that a subgroup of patients developed a post-infectious IBS after an episode of gastroenteritis. Various studies have revealed that the fecal microbiota changes in IBS and IBS symptoms can be restored by therapeutic interventions that act on the microbiota. This is where the fecal transplant for IBS comes into play.
What is Fecal Transplant for IBS?
A fecal transplant, also called fecal microbiota transplant (FMT) or bacteriotherapy, is a technique that involves the introduction of healthy bacteria and microbes from a donor’s gut into the affected patient’s gut. Several studies involving patients with mild to severe IBS-D and IBS-C have revealed positive results when a fecal transplant is used in the treatment of IBS. While the results of the research available show promising results, further research is needed to support the effectiveness of fecal transplant for IBS.
Who Should Consider a Fecal Transplant for IBS?
There are trillions of live, valuable strains of bacteria that reside in our colons. The stool itself consists of more than 500 types of bacteria and possibly 4,000 different microbes that live in the gut “microbiome.”
Your microbiome is like a small world or ecosystem that consists of all the good and harmful bacteria that regulate the process of nutrient digestion in your body. Its uniqueness is similar to a fingerprint and reveals all the harms your gut has suffered, including those from medications, antibiotics, parasites and processed foods, depending on what has passed through your gut over your lifetime. With the fecal transplant, it is now possible to remove all the bad bacteria that grew from gut misuse and replace them with an entirely new strain of healthy bacteria that your body can use to process valuable nutrition and develop new healthy cells.
Although several drugs are currently available for this condition, you should know there are other treatment options for IBS.
People with digestive infections and conditions like IBS, ulcerative colitis and Crohn’s disease usually have a high amount of destructive bacteria residing in their gut and a low amount of normal and healthy bacteria. Either because of a digestive condition or some lifestyle factors, including consumption of an unhealthy diet and long-term usage of antibiotics, the healthy bacteria that are typically present have been suppressed or destroyed. So, for individuals with such a destabilized gut, a fecal transplant would prove to be valuable.
How is a Fecal Transplant Performed?
There are various methods of performing a fecal transplant for IBS. Each method has its own benefits. You should work closely with your doctor to identify a method that will work perfectly for you. Below are four methods that doctors use to perform a fecal transplant.
Colonoscopy
This technique introduces a liquid stool preparation straight into your large intestine through a colonoscopy. Mostly, the colonoscopy tube is driven through the hole of your large intestine. The tube leaves the stool preparation in your intestine as it pulls out. One benefit of using a colonoscopy is that it allows doctors to view parts of your large intestine that could be affected by an underlying medical condition.
Enema
Just like the colonoscopy method, this approach delivers the transplant straight into your large intestine via an enema. Your doctor may ask you to lie on your side with your lower body raised to allow the transplant to get to your intestine effortlessly. Next, they will slowly insert a lubricated enema tip into your rectum. Then, the transplant that is contained in an enema bag will stream into the rectum. Fecal transplants delivered through enema are usually minimally invasive and less expensive than colonoscopies.
Nasogastric Tube
This procedure involves delivering a liquid stool preparation to your stomach through a tube that starts from your nose and runs all the way to the stomach. The stool then moves to your large intestine. Before the procedure, your doctor will give you a medication to prevent your stomach from releasing acid that could harm or kill valuable organisms in the stool preparation. Then, they will put the tube into your nose and push it into your stomach and use imaging technology to check if the tube is properly positioned. Most medical professionals use a syringe to introduce the transplant preparation into the tube.
Capsules
This is the latest method of transplanting stool into the gut. Patients swallow a couple of pills consisting of a transplant preparation. It is undoubtedly less invasive than other methods. Moreover, patients can do it in a medical office or in the comfort of their homes. More research is needed to determine the effectiveness and safety of swallowing capsules containing stool preparation.
Side Effects of Fecal Transplant
A fecal transplant for IBS may come with a few side effects, including:
- Abdominal pain or cramping
- Bloating
- Constipation
- Diarrhea
- Flatulence
Though rare, the pain may become severe. You may also see blood in your stool or experience serious abdominal swelling and vomiting. If you experience such adverse effects, get in touch with your doctor right away.
In Conclusion
The effectiveness of a fecal transplant for IBS is still poorly understood, however, available research has shown positive results. In fact, several early studies have shown that 65% of patients who received fecal transplant realized a brief relief from their IBS symptoms. The risks linked to fecal transplant for IBS are few, uncommon and usually mild. Therefore, fecal transplant may be a great method to treat IBS and its symptoms, but lengthier and larger studies must be carried out to give us a better understanding of this therapy.
