Washed microbiota transplantation improves symptoms of functional constipation at 4 weeks
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Key takeaways:
- The overall response rates to washed microbiota transplantation were 49.2%, 50.8% and 42.9% at 4, 8 and 24 weeks.
- At week 4, the rates of clinical remission and clinical improvement were 54% and 68.3%.
Washed microbiota transplantation improved straining, hard stools and reduced stool frequency among patients with refractory functional constipation, with greater efficacy reported with additional courses of treatment.
“Washed microbiota transplantation (WMT) is a microbiota transplantation method that is similar to traditional fecal microbiota transplantation but with a modification in that the washed microbiota prepared by an intelligent microorganism separation system, instead of the fecal microbiota, is used,” Liquan Wu, of the First Affiliated Hospital of Guangdong Pharmaceutical University, and colleagues wrote in BMC Gastroenterology. “WMT has been proven to be superior to the fecal microbiota in the safety, quality control and efficacy in the treatment of bacterial flora disorders.”
They continued: “However, it is difficult to quantitatively evaluate the overall efficacy of WMT for functional constipation.”
In a retrospective analysis, researchers collected data on 63 patients (mean age, 60.8 years; 54% women) with refractory functional constipation (FC) who underwent a total of 112 courses of WMT. Patients were monitored for approximately 24 weeks after the first course of WMT via hospital visits and telephone interviews.
Primary outcomes included improvement in therapeutic targets, such as straining, hard stool and incomplete evacuation, as well as overall response at weeks 4, 8 and 24. Secondary outcomes included rates of clinical remission and improvement, stool frequency, Wexner constipation score, Bristol Stool Form Scale (BSFS) score and adverse events.
According to results, patients underwent one (n = 37), two (n = 10), three (n = 9) or four (n = 7) courses of WMT. At baseline, patient complaints included straining (95.2%), hard stools (90.5%), incomplete evacuation (22.2%), a sense of anorectal obstruction (14.3%) and decreased stool frequency (73%).
Results showed improvement rates at weeks 8 and 24 for straining (45.6% and 35%, respectively), hard stools (42.9% and 38.6%), incomplete evacuation (45% and 35.7%), a sense of anorectal obstruction (55.6% and 44.4%) and decreased stool frequency (60.9% and 50%).
The overall response rates at weeks 4, 8 and 24 were 49.2%, 50.8% and 42.9%, respectively, while rates of clinical remission and clinical improvement reached their peak at 54% and 68.3% at week 4. Stool frequency, BSFS score and Wexner constipation score also improved from baseline values.
Researchers reported 12.7% of participants experienced 22 treatment-related adverse events during the procedure and follow-up, of which diarrhea (7% and 0.9%, respectively), abdominal pain (3.6% and 0.9%) and bloating (3.6% and 1.8%) were the most common. There were no serious adverse events.
“WMT is efficacious in treating refractory FC-related therapeutic targets, especially straining, hard stools and decreased stool frequency,” Wu and colleagues concluded. “The efficacy is increased with more than one course of WMT. However, a large-scale prospective study is required to further confirm the benefits of WMT for FC in terms of therapeutic targets.”
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