title: [Efficacy analysis of fecal microbiota transplantation in the treatment of 406 cases with gastrointestinal disorders].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for gastrointestinal disorders.
  
  
  METHODS
  Retrospective analysis of the clinical data of 406 patients who underwent FMT from May 2014 to April 2016 in the Intestinal Microenvironment Treatment Centre of Nanjing General Hospital was performed, including patients with constipation(276 cases), recurrent Clostridium Difficile infection (RCDI, 61 cases), ulcerative colitis(44 cases), irritable bowel syndrome (15 cases) and Crohn's disease(10 cases). Donors were completely unrelated, 18- to 50-year-old non-pregnant healthy adult, with healthy lifestyle and habits, without taking antibiotics, probiotics and other probiotics history within 3 months. There were three routes of FMT administration: patients received 6 days of frozen FMT by nasointestinal tube placed in the proximal jejunum under gastroscope (319 cases); patients received capsules FMT per day for 6 consecutive days (46 cases) or once 600 ml of treated fecal liquid infusion into colon and terminal ileum by colonoscopy(41 cases).
  
  
  RESULTS
  Clinical cure rate and improvement rate of different diseases receiving FMT were respectively as follows: RCDI was 85.2% (52/61) and 95.1%(58/61); constipation was 40.2%(111/276) and 67.4%(186/276); ulcerative colitis was 34.1%(15/44) and 68.2% (30/44); irritable bowel syndrome was 46.7% (7/15) and 73.3% (11/15) and Crohn disease was 30.0%(3/10) and 60.0%(6/10). RCDI had the best efficacy among these diseases(P<0.01). There was no significant difference between the three routes of FMT administration(P=0.829). The clinical cure rate and improvement rate of different routes were 43.3%(138/319) and 58.6% (187/319) respectively in nasogastric transplantation group, 41.5%(17/41) and 61.0%(25/41) in colonoscopy group, 37.0%(17/46) and 63.0% (29/46) in the capsule transplantation group. There was no serious adverse event during the follow-up. The most common side effects were respiratory discomfort (27.3%, 87/319) and increased venting (51.7%, 165/319) in nasogastric transplantation group. Diarrhea was the most common complication in colonoscopy group (36.6%, 15/41). The main symptoms were increased venting (50.0%, 23/46) and nausea(34.8%, 16/46) in oral capsule group. Side effect symptoms disappeared after the withdraw of nasogastric tube, or at the end of treatment, or during hospitalization for 1-3 days.
  
  
  CONCLUSIONS
  FMT is effective for many gastrointestinal disorders. No significant adverse event is found, while the associated mechanism should be further explored.
authors.affiliation: Intestinal Microenvironment Treatment Center, Department of General Surgery, Nanjing General Hospital, Nanjing 210002, China. liningrigsnju@163.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Hongliang
authors.initials: H
authors.lastname: Tian
authors.forename: Chunlian
authors.initials: C
authors.lastname: Ma
authors.forename: Chao
authors.initials: C
authors.lastname: Ding
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Ge
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.forename: Xuelei
authors.initials: X
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.forename: Yue
authors.initials: Y
authors.lastname: Hua
authors.forename: Yifan
authors.initials: Y
authors.lastname: Zhu
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000328:Adult; D016360:Clostridioides difficile / Q000187:drug effects*; D003015:Clostridium Infections / Q000188:drug therapy*; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods; D003248:Constipation / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced; D000069467:Fecal Microbiota Transplantation / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D005414:Flatulence / Q000139:chemically induced; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D012189:Retrospective Studies; D016896:Treatment Outcome