Comparison of the Fecal Microbiota Transplantation and ACHIM Suspension for Manipulating the Gut Microbiota in Patients With Irritable Bowel Syndrome

Fecal transplantation (FMT), the infusion of a fecal preparation from a healthy donor into the gastrointestinal tract of another human being is capable of altering the gut microbiome of the new host. There is speculation that human faeces from a healthy donor may constitute the ideal "probiotic", thus suggesting FMT as a treatment option for conditions where an altered microbiota has been detected, including irritable bowel syndrome (IBS) . Anaerobically Cultivated Human Intestinal Microbiota (ACHIM) is an alternative way to manipulate gut microbiota instead of FMT. ACHIM suspension is a natural ecosystem of normal intestinal bacteria cultivated and propagated regularly in the laboratory (in vitro). After 20 years of cultivation ACHIM has retained the same rich biodiversity as the original stool sample, originating from a healthy donor in 1995. ACHIM can restore the ecological balance of the gut when it has been disturbed (dysbiosis) e.g. after antibiotic treatment. ACHIM has until now been given to over 400 patients (most of them suffering from recurrent Clostridium difficile infection) without any serious side effects being observed. Microbiological tests have shown that ACHIM is a well-balanced functional microbiota, and contains the major bacterial phyla Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria .

Thus, in the present study aims at comparing these methods safety and efficacy in relieving symptoms in patients with IBS. Given the ethical concerns of unknown and long-term adverse effects of FMT therapy, only patients with moderate to severe symptoms will be included.

Aim:

The primary aim of this open pilot study was to compare these two gut manipulating methods (FMT and ACHIM) in IBS patients.

The secondary aims were as follows;