Summary
- Enterosgel is currently being tested for its benefits in IBS-D in a national trial in the UK and has been accepted by the British Society of Gastroenterology as a treatment option for digestive issues.
RESEARCH OVERVIEW
In recent years, there has been considerable interest in the evaluation of faecal microbiota transplantation (FMT) for IBS. Unfortunately, a meta-analysis of 5 RCTs, containing 267 patients, demonstrated no significant benefit of FMT compared with placebo (RR 0.98; 95% CI 0.58 to 1.66), and in 2 pooled trials placebo capsules administered orally were superior to capsules containing donor stool (RR 1.96; 95% CI 1.19 to 3.20).294.
Criticisms of the trials, to date, have included small sample sizes, heterogeneity in IBS subtypes recruited, lack of standardisation of donor samples and suboptimal endpoints used. There is therefore a need for further, large, high-quality trials of FMT for IBS, perhaps targeting subgroups of patients with evidence of dysbiosis, who may be more likely to benefit. At present, therefore, there is insufficient evidence to recommend FMT for IBS outside of a research setting.
Enterosgel, an intestinal adsorbent approved for use in IBS-D and available over-the-counter in the UK is currently the subject of a multicentre RCT in IBS-D.
