ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Fecal Microbiota Transplantation For The Treatment Of Irritable Bowel Syndrome

Updated on September 30, 2016

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, (and one of the most common gastrointestinal diseases worldwide), with no clear underlying causative factor and no single effective and curing treatment known.

The diagnosis is based on exclusion of other diseases of the gut, by appropriate tests, imaging, and possible colonoscopy, and the presence of the characteristic symptoms of IBS.

The occurrence of IBS in the general population is estimated to be around 15% or more, as many people don't seek medical help when the symptoms are mild.

Fecal Bacteria
Fecal Bacteria

What's the role of colonic bacteria in health and disease?

During the last few years, more attention was paid to bacteria in the colon (large bowel) as a significant determinant for the development of IBS.

Bacteria are normally present in the colon, and is called “normal flora”, which doesn't cause disease, rather it helps in digestion, and even provide us with vitamins, B and K, they synthesizes.

Colonic bacteria is also called “microbiota”, a word that means : microscopic living organisms

In subjects with IBS this bacterial flora demonstrates differences from that of unaffected subjects, which is essentially a different bacterial flora (or microbiota) population.

In other words, the species of bacteria and their numbers differ from that of normal, creating a colonic medium that favours and triggers the development of IBS symptoms.

Vials containing "donated" fecal material
Vials containing "donated" fecal material

Colonic bacterial infections , is a well known strong trigger of IBS. Bacterial infections commonly cause diarrhea, and increased “washing out” of healthy microbiota, another factor which adds to the process of microbiota population change.

Symptoms of IBS persist even after an infection subsides, a fact that supports the role of unhealthy microbiota in the causation of IBS.

Based on these facts, it was suggested that if this “unhealthy” medium in the colon, is restored back to normal, it would theoretically help curing IBS.

Of course, genetic and environmental factors may also play a role in IBS, along with the presence of abnormal colon motility, increased sensitivity to pain when the colon distends with gas, and the influence of signals coming from the brain.

Why Fecal Microbiota Transplantation?

The idea of restoring colonic microbiota to normal, was further polished, and the way how to change the colonic bacterial flora was already there and was used to successfully cure other colonic diseases. It's fecal microbiota transplantation (FMT).

FMT denotes the process of transferring the normal “microbiota” from a normal person to the patient's colon in order to replace his/her “unhealthy microbiota”, with the healthy “donated” substitute.

FMT is considered as a curative therapy for “Clostridium difficile” infection (a bacterial infection that causes diarrhea and can resist antibiotics), with restoration of normal microbiota and complete recovery.

The other disease that responded to FMT is inflammatory bowel disease.

Since the principle is the same, FMT has been tried for treating IBS symptoms, with obvious success.

How altering the colonic microbiota can cure gut disorders, including IBS?

Microbiota and immunity

The presence of normal microbiota is essential for the immunity of the gut. It has been linked to the normal development of the lymphoid cells in the gut ,an important first-line defence system.

When the microbiota is altered (as in persons suffering from IBS),this system becomes abnormally and inappropriately activated , producing a mild and ongoing inflammatory process, which is thought to be responsible, in part, for pain.

In addition, the colonic lining becomes permeable, so that it no longer acts as a defence barrier against threats from the gut lumen.

Microbiota and the brain:

A second role of microbiota is to connect between the brain and the gut, in a way that any stress, either psychological or physical, will affect the biological properties of colonic microbiota. The latter, then enhances the colonic wall sensitivity to pain.

Bacterial infections of the colon can significantly change the composition of the colonic microbiota, an effect that may trigger the development of IBS.

The same can happen with the use of antibiotics, since antibiotics kill certain types of microbes, allowing other types to grow, and the final outcome would be a change in microbiota composition.

In contrary, treatment with probiotics (microorganisms that have beneficial health effects when consumed), normalizes the microbiota population, and the sensitivity of the colon to pain diminishes, hence, symptoms of IBS get relieved.

What' are the characteristic properties of microbiota in IBS?

Patients with IBS have the following important microbiota features:

- Less numbers of the bacteria known as “Lactobacillus” , “Bifidobacterium” , “Bacteroidetes”, and “Actinobacteria”

- Increased numbers of the bacteria “Enterobacteraceae” and “Firmicutes”

These differences in the composition of microbiota in IBS patients from the normal, suggested that restoration of the normal microbiota may help curing the disorder, a process that can be achieved by FMT.

Furthermore, differences in the microbiota have been recognized between the different subtypes of IBS : diarrhea-predominant, constipation-predominant, and mixed subtypes.

How effective is Fecal Microbiota Transplantation in treating IBS?

FMT has been already shown to be effective in the treatment of Clostridium difficile infection.

But recently, the fact that FMT is likely to be effective in other diseases, including IBS, has been studied, with very promising results.

The success rate of treating IBS with FMT, reaches 70-90% as studies showed.

How is the “donor” of the fecal material selected?

A donor is the subject who donates his/her feces to be “transplanted” in the patient's gut.

Before transplantation, a donor should be screened for infectious diseases, to ensure safety of the procedure.

A donor shouldn't have practised high risk behaviours, like illicit intravenous drug abuse, which expose to the risk of acquiring infections.

Additionally, a donor shouldn't have used antibiotics or medications that suppress immunity, within the preceding 3 months, because these can change the composition of the normal donor's microbiota.

How Fecal Microbiota Transplantation is done?

The fecal material of the donor, when processed is infused into the gut by any of these methods:

-A nasogastric tube: a slim flexible tube that's passed through the nostril and advanced down to the stomach.

-A nasoenteric tube: similar to the nasogastric tube, but is further pushed into the small bowel.

-Endoscopy : either upper endoscopy, or lower endoscopy (colonoscopy).


Among the above mentioned routes, colonoscopy is associated with better results in patients treated for Clostridium difficile infection, though it's still not clear which of them is most appropriate for treating IBS.

Further research is required to determine the optimal route of FMT administration for patients with IBS.

Is FMT acceptable by people?

Studies showed that FMT acceptance is very high (more than 95%), although some routes through which the material is infused are less acceptable, as in the case of upper endoscopy or nasogastric tube, in comparison with colonoscopy or enema, which are best preferred.

Recently, a manufactured capsule containing the microorganisms thought to be responsible for the healing effect of FMT, is available and may revolutionize this kind of treatment when its efficacy is proven.

Safety of FMT:

Since FMT requires the inoculation of a very dirty and highly contaminated material from one person to another, a theoretical risk of transmitting infectious diseases is always there.

Human feces contains thousands of strains of bacteria, some are beneficial, and some are harmful.

The results of the available studies on FMT, proved that when the donor is properly selected and thoroughly screened for contagious diseases, the risk of complications is extremely negligible.

Is FMT currently used for treating IBS?

While FMT is becoming increasingly available and permitted by regulations for use as a treatment option for patients with Clostridium difficile infection, it's use for IBS is still under strict control.

Further studies are needed to strengthen the evidence of FMT efficacy for curing IBS symptoms, in order to be recommended as a standard therapy.

So how will be the future of FMT?

Based on the available data, FMT is going to be an effective, and curing treatment for IBS sufferers.

The evidence is growing day-by-day, to support this relatively newly applied method of managing some gut disorders, to include also other functional gut disorders, and not just IBS.

Do you think fecal transplantation can cure irritable bowel syndrome?

See results


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)