title: [Short-term efficacy on fecal microbiota transplantation combined with soluble dietary fiber and probiotics in the treatment of slow transit constipation].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) combined with soluble dietary fiber and probiotics for slow transit constipation(STC).
  
  
  METHODS
  Twenty-three patients with STC from Jinling Hospital, Medical School of Nanjing University were prospectively enrolled between April 2015 and January 2016. STC patients received FMT combined with soluble dietary fiber and probiotics. Fresh stool(100 g) was immediately mixed in a blender with 500 ml of 0.9% sterile saline for several seconds, which was then filtered through a gauze pad and a decreasing number of gauze screen (2.0 to 0.5 mm). The fecal bacteria suspension was stored frozen at -20centi-degree. The preparation time of FMT material was less than 1 hour. Total time of treatment was 9 days. An initial oral antibiotics(vancomycin 500 mg orally twice per day) was given for 3 consecutive days. Then the fecal microbiota(100 ml) was infused slowly(5 min) through nasojejunal tube for 6 consecutive days. After FMT, patients were recommended to receive soluble dietary fiber (pectin, 8 g/d) and probiotics (bifid triple viable capsules, twice per day) for 4 weeks. Rates of clinical improvement and remission, adverse events, constipation-related symptoms (PAC-SYM scores), bowel movements per week and gastrointestinal quality-of-life index (GIQLI) were recorded during the 12-week follow-up. This study was registered in the Clinical Trials.gov (NCT02016469).
  
  
  RESULTS
  Among 23 patients, 7 were male, 16 were female, the mean age was (49.6±14.7) years, the body mass index was (21.2±2.2) kg/m2, the duration of constipation was (8.3±5.9) years, and the defecation frequency was 1.8±0.7 per week. Compared with pre-treatment, PAC-SYM scores decreased significantly from 2.3±0.5 to 1.3±0.4 at week 12 (P<0.01), defecation frequency increased from 1.8±0.7 per week to 4.8±2.0 per week at week 12 (P<0.01), and patients felt satisfied with improved GIQLI score (from 78.5±15.5 to 120.8±21.3, P<0.01). During the follow-up, the clinical improvement and remission of STC patients reached 69.6%(16/23) and 52.2%(12/23), respectively. No serious adverse events were observed.
  
  
  CONCLUSIONS
  FMT combined with soluble dietary fiber and probiotics is safe and effective in treating slow transit constipation, which can improve the symptom and quality of life significantly.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Ge
authors.forename: Chao
authors.initials: C
authors.lastname: Ding
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.forename: Hongliang
authors.initials: H
authors.lastname: Tian
authors.forename: Yao
authors.initials: Y
authors.lastname: Wei
authors.forename: Qiyi
authors.initials: Q
authors.lastname: Chen
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China. liningrigs@vip.sina.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003248:Constipation; D003672:Defecation; D004043:Dietary Fiber; D000069467:Fecal Microbiota Transplantation; D005243:Feces; D005260:Female; D005767:Gastrointestinal Diseases; D006801:Humans; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D010368:Pectins; D019936:Probiotics; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D004043:Dietary Fiber; D010368:Pectins