Current Applications of Fecal Microbiota Transplantation in Functional Constipation

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Abstract

Functional constipation (FC) is a common condition that would be hard to treat in clinical practice with a prevalence incidence in the population. Pharmacotherapy is a common treatment modality. However, clinical effects are limited and patients continue to suffer from it. In recent years, with the gradual increase in research on gut microbiota, it is understood that dysbiosis of the gut microbiota is importantly associated with the development of constipation. Recent studies have shown that fecal microbiota transplantation (FMT) is an effective method for restoring gut microbiota, as well as being efficacious in the treatment of FC. This mini review explains the characteristics of gut microbiota in FC patients, the mechanism of action of FMT, treatment modalities, current efficacy, and related problems. The purpose is to provide research directions and references for the future applications of FMT in FC.

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Human gut microbiome: hopes, threats and promises

Patrice Cani (2018)

The microbiome has received increasing attention over the last 15 years. Although gut microbes have been explored for several decades, investigations of the role of microorganisms that reside in the human gut has attracted much attention beyond classical infectious diseases. For example, numerous studies have reported changes in the gut microbiota during not only obesity, diabetes, and liver diseases but also cancer and even neurodegenerative diseases. The human gut microbiota is viewed as a potential source of novel therapeutics. Between 2013 and 2017, the number of publications focusing on the gut microbiota was, remarkably, 12 900, which represents four-fifths of the total number of publications over the last 40 years that investigated this topic. This review discusses recent evidence of the impact of the gut microbiota on metabolic disorders and focus on selected key mechanisms. This review also aims to provide a critical analysis of the current knowledge in this field, identify putative key issues or problems and discuss misinterpretations. The abundance of metagenomic data generated on comparing diseased and healthy subjects can lead to the erroneous claim that a bacterium is causally linked with the protection or the onset of a disease. In fact, environmental factors such as dietary habits, drug treatments, intestinal motility and stool frequency and consistency are all factors that influence the composition of the microbiota and should be considered. The cases of the bacteria Prevotella copri and Akkermansia muciniphila will be discussed as key examples.

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Fecal microbiota transplantation: Review and update

Deng-Chyang Wu, Jaw-Yuan Wang, Ping-I Hsu … (2018)

Fecal microbiota transplantation (FMT) is a method to directly change the recipient's gut microbiota to normalize the composition and gain a therapeutic benefit. The history of FMT has been traced back to the 4th century and has been highly regarded since 2013, when the United States Food and Drug Administration approved FMT for treating recurrent and refractory Clostridium difficile infection. Since then, the range of FMT applications extended rapidly and broadly not only in gastrointestinal disorders, but also in extra-gastrointestinal diseases. Donor selection with questionnaire, interview, blood tests, and stool examinations should be strictly performed before FMT to reduce and prevent occurrence of any adverse events. Step-by-step cautious fecal and recipient preparation along with adequately choosing delivery methods based on individual clinical situations are key points of the FMT process. Although current evidence deems FMT as a generally safe therapeutic method with few adverse effects, the long-term outcomes of FMT have not been completely elucidated. Therefore, establishing periodicity and length of regular follow-up after FMT to monitor the clinical efficacy and long-term adverse events are other essential issues. In the future, we will look forward to personalized FMT for different patients and conditions according to varied hosts and diseases.

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Relationship Between Microbiota of the Colonic Mucosa vs Feces and Symptoms, Colonic Transit, and Methane Production in Female Patients With Chronic Constipation.

Gopanandan Parthasarathy, Jun Chen, Xianfeng Chen … (2016)

In fecal samples from patients with chronic constipation, the microbiota differs from that of healthy subjects. However, the profiles of fecal microbiota only partially replicate those of the mucosal microbiota. It is not clear whether these differences are caused by variations in diet or colonic transit, or are associated with methane production (measured by breath tests). We compared the colonic mucosal and fecal microbiota in patients with chronic constipation and in healthy subjects to investigate the relationships between microbiota and other parameters.

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Author and article information

Contributors

Xiao Ke:

ORCID: https://orcid.org/0000-0002-9985-035X

Journal

Journal ID (nlm-ta): Evid Based Complement Alternat Med

Journal ID (iso-abbrev): Evid Based Complement Alternat Med

Journal ID (publisher-id): ECAM

Title: Evidence-based Complementary and Alternative Medicine : eCAM

Publisher: Hindawi

ISSN (Print): 1741-427X

ISSN (Electronic): 1741-4288

Publication date Collection: 2022

Publication date (Electronic): 13 July 2022

Publication date PMC-release: 13 July 2022

Volume: 2022

Electronic Location Identifier: 7931730

Affiliations

¹The Second People's Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou 350003, China

²Fujian Clinical Medical Research Centre of Chinese Medicine for Spleen and Stomach, Fuzhou 350003, China

Author notes

Academic Editor: Duygu Ağagündüz

Author information

Xiao Ke https://orcid.org/0000-0002-9985-035X

Article

DOI: 10.1155/2022/7931730

PMC ID: 9300281

SO-VID: 4d3305b3-5139-46aa-9f6b-43c207acaa8f

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This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 16 May 2022

Date accepted : 22 June 2022

Funding

Funded by: National Construction Project of Regional Diagnostic and Treatment Chinese Medicine Specialist Center

Award ID: 2100202

Funded by: Outstanding Contribution of Young and Middle-Aged Experts in Health in Fujian Province Funding Project

Award ID: 2109999

Current Applications of Fecal Microbiota Transplantation in Functional Constipation

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The International Journal of Person Centered Medicine

Most cited references 30

Human gut microbiome: hopes, threats and promises

Fecal microbiota transplantation: Review and update

Relationship Between Microbiota of the Colonic Mucosa vs Feces and Symptoms, Colonic Transit, and Methane Production in Female Patients With Chronic Constipation.

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