Fecal microbiota transplantation in IBS

Dr Paul Moayyedi is a professor in the Division of Gastroenterology at McMaster University, Richard Hunt/AstraZeneca Chair in Gastroenterology, and the inaugural assistant dean of research.

Is fecal microbiota transplantation (FMT) beneficial for patients with irritable bowel syndrome (IBS)?

Paul Moayyedi, BSc, MB ChB, PhD, MPH: That is an interesting question. The honest answer is we do not know. To date there have been 4 randomized trials on this topic, involving about 250 patients. Two of those trials suggested benefit, 2 of those trials were reported as negative. If you look at the data, there was a trend to harm and overall, when you pool the data, there is absolutely no benefit whatsoever. But I think that is hiding studies where there was benefit versus studies where there was harm.

It emphasizes we need to understand better how to change the microbiota before we use this therapy in IBS. Certainly it should not be used outside of a clinical trial, and I suspect it will be a few years before we understand what we are doing in this regard and before we can help patients with IBS.