title: Treatment of Slow Transit Constipation With Fecal Microbiota Transplantation: A Pilot Study.
abstract: Fecal microbiota transplantation (FMT) has been proposed as a therapeutic approach for functional gastrointestinal disease. We launched a clinical study to examine the safety and efficacy of FMT for slow transit constipation (STC).
  
  
  
  Twenty-four patients with STC, aged from 20 to 74 were enrolled in this prospective open-label study. Patients received FMT on 3 consecutive days through nasojejunal tubes and followed up for 12 weeks after treatment. Rate of clinical improvement and remission, Wexner constipation scale, Bowel movement per week, and gastrointestinal quality-of-life index were evaluated.
  
  
  
  The rate of clinical improvement and remission based on clinical activity at week 12 was 50% (12/24) and 37.5% (9/24), respectively. The patient's stool frequency increased from a mean of 1.8 (SD 1.3) per week pre-FMT to 4.1 (SD 2.6) at week 12 post-FMT without laxative usage (P<0.01). The stool consistency showed a tendency to improve after FMT administration. Comparison of pre-FMT and post-FMT Wexner constipation scores demonstrated a significant reduction between baseline (14.1±3.3) and the first week (9.8±4.9), which was maintained up to the following 12 weeks (7.5±3.2; P<0.01). Compared with baseline, significant overall improvements were also seen in gastrointestinal quality-of-life index score at week 1, week 2, week 4, week 8, and week 12 of follow-up (P<0.01). The improvements were accompanied by the decline of colonic transit time. No severe adverse events during the whole FMT procedure follow-up except for venting (6/24), abdominal pain (3/24), bloating (2/24), and diarrhea (7/24).
  
  
  
  This is a pilot study demonstrating that FMT was safe and may have the potential to improve symptoms in patients with STC.
authors.affiliation: *Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China †Department of Medicinal Chemistry, University of Washington, Seattle, WA.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Tian
authors.forename: Chao
authors.initials: C
authors.lastname: Ding
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Ge
authors.forename: Lynne V
authors.initials: LV
authors.lastname: McFarland
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.forename: Yao
authors.initials: Y
authors.lastname: Wei
authors.forename: Qiyi
authors.initials: Q
authors.lastname: Chen
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003248:Constipation / Q000382:microbiology / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult