AI Article Synopsis
- Fecal microbiota transplantation (FMT) is a promising treatment for recurrent Clostridioides difficile infections, and understanding its distribution in the colon through different delivery methods is crucial.
- In a study with eight participants, contrast fluid was administered via colonoscopy and enema to compare how well it reached different parts of the colon, revealing that colonoscopy effectively reaches the cecum, while enemas provide more variable results.
- Results indicated that while enema delivery does reach the proximal colon, colonoscopy remains the most reliable method, highlighting the need for further research on how the distribution of FMT relates to its effectiveness in treating infections.
Article Abstract
Background: Fecal microbiota transplantation (FMT) has become an important treatment method in recurrent Clostridioides difficile infections and is under investigation as a treatment for several other diseases. FMT's mechanism of action is assumed to be through alterations of the colon microbiota. FMT can be delivered by several methods, but few studies have directly compared how FMT is distributed in the colon by different methods. Specifically, the proximal distribution of FMT delivered by enema is unknown.
Methods: In eight participants, we administered contrast fluid (CF) with viscosity similar to an FMT in a crossover study design. First, CF was administered by colonoscopy, followed by an abdominal X-ray to visualize the CF distribution. Next, after four to eight weeks, participants were given CF, but as an enema, followed by a positioning procedure. X-rays were obtained before (enema ÷) and after (enema +) the positioning procedure.
Conclusion: Proportion of participants with CF in cecum were 100% after colonoscopy, 50% after enema + and 38% after enema ÷. In the transverse colon, proportions were 100% (colonoscopy), 88% (enema +) and 63% (enema ÷). There were no adverse events.
Interpretation: This study shows proof of concept for the distribution of FMT to proximal colon when delivered by enema. A positioning procedure after the enema slightly improves the proximal distribution. However, colonoscopy is the only method that ensures delivery to the cecum. Studies are needed to see if FMT colon distribution correlates with treatment effectiveness.
Trial Registration: The study was retrospectively registered at ClinicalTrials.gov (NCT05121285) (16/11/2021).
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594821 | PMC |
| http://dx.doi.org/10.1186/s12876-023-02979-x | DOI Listing |
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