J Neurogastroenterol Motil.  2017 Apr;23(2):289-297. 10.5056/jnm16074.

Serial Frozen Fecal Microbiota Transplantation in the Treatment of Chronic Intestinal Pseudo-obstruction: A Preliminary Study

• Gu L
• Ding C
• Tian H
• Yang B
• Zhang X
• Hua Y
• Zhu Y
• Gong J
• Zhu W
• Li J
• Li N

• KMID: 2433530
• DOI: http://doi.org/10.5056/jnm16074

Abstract

BACKGROUND/AIMS
Chronic intestinal pseudo-obstruction (CIPO) is a serious, life-threatening motility disorder that is often related to bacterial overgrowth. Fecal microbiota transplantation (FMT) results in restoration of the normal intestinal microbial community structure. We investigated the efficacy of FMT in the treatment of CIPO patients.
METHODS
Nine patients (age 18-53 years) with CIPO were enrolled in this prospective, open-label study. Patients received FMT for 6 consecutive days through nasojejunal (NJ) tubes and were followed up for 8 weeks after treatment. We evaluated the rate of clinical improvement and remission, feeding tolerance of enteral nutrition, and CT imaging scores of intestinal obstructions. Lactulose hydrogen breath tests were performed before FMT and 8 weeks after FMT to evaluate for the presence small intestinal bacterial overgrowth (SIBO).
RESULTS
FMT significantly alleviated bloating symptoms, and symptoms of pain were relieved 2 weeks after FMT. Enteral nutrition administered through a NJ tube after FMT was well-tolerated by 66.7% (6/9) of patients. CT scores of intestinal obstructions were significantly reduced after FMT (P = 0.014). SIBO was eliminated in 71.0% (5/7) of patients.
CONCLUSIONS
This pilot study demonstrated the safety of using FMT. FMT may relieve symptoms in selected patients with CIPO. FMT may also improve patient tolerance of enteral nutrition delivered via a NJ tube.

Keyword

Intestinal pseudo-obstruction; Fecal microbiota transplantation; Tolerance of enteral nutrition

MeSH Terms

Breath Tests
Enteral Nutrition
Fecal Microbiota Transplantation*
Humans
Hydrogen
Intestinal Obstruction
Intestinal Pseudo-Obstruction*
Lactulose
Pilot Projects
Prospective Studies
Hydrogen
Lactulose