Outcomes and prognostic factors of fecal microbiota transplantation in patients with slow transit constipation: results from a prospective study with long-term follow-up
Open accessAbstract
BACKGROUND AND AIM: Gut microbiota may contribute to regulate colonic motility, which is involved in the etiology of constipation. Fecal microbiota transplantation (FMT) has been demonstrated to restore intestinal homeostasis. The aim of this study was to evaluate the clinical outcomes and prognostic factors of FMT for the treatment of slow transit constipation (STC). METHODS: Fifty-two patients with STC received standardized FMT and were followed up for 6 months. Bowel habit, colonic transit time, constipation-related symptoms (PAC-SYM score), quality of life (PAC-QOL score), treatment satisfaction scores and adverse events were monitored. The primary efficacy endpoint was the proportion of patients having on average three or more complete spontaneous bowel movements (CSBMs) per week. RESULTS: < 0.01 for all comparisons). Significant improvements were also observed in other bowel movement assessments, colonic transit time, constipation-related symptoms and quality of life; but all improvements diminished at weeks 12 and 24. Incompleteness of evacuation served as the only factor associated with efficacy. No serious treatment-related adverse events were observed. CONCLUSION: This study suggested FMT was effective and safe for STC, while a late loss of efficacy was also observed. A lower degree of sensation of incompleteness predicted a better outcome.
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Interventions with probiotics, prebiotics, and fecal-microbiota transplantation improved colonic transit and defecation frequency.
“interventions with probiotics, prebiotics, and fecal-microbiota transplantation improved colonic transit and defecation frequency [ 21–23 ]”
From Role of gut microbiota in functional constipation (2021) · cites this paper as [23]
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“Faecal microbiota transplantation (FMT) has shown good clinical efficacy in the treatment of various clinical diseases, such as refractory Clostridium difficile infection,([2]) irritable bowel syndrome,([3]) inflammatory bowel disease,([4]) and constipation.([5]) Animal studies have proven that FMT can improve radiati…”
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“suggested that FMT was effective and safe for slow transit constipation (STC) (Ding et al., 2018).”
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“weeks) was superior to long-term efficacy (1 year) [24].”
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“In the study by Ding et al. [19], after FMT, the percentage of patients achieving primary efficacy endpoint (at least three CSBMs per week) over the week intervals 3–4, 9–12, and 21–24 increased to 50.0%, 38.5%, and 32.7%, respectively.”
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“FMT has been shown to be superior to placebo in the treatment of IBS [22–24] and FC [25–27].”
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“…nasojejunal tube; FMT, faecal microbiota transplantation; BMI, body mass index. diseases, which include ulcerative colitis [1], Crohn ’ s disease [2], irritable bowel syndrome [3], functional constipation [4], radiation enteritis [5], hepatitis B [6], cirrhosis [7], and hepatic encephalopathy [8].”
BackgroundFaecal microbiota transplantation: what’s beyond Clostridium difficile infection?
Tamilarasan, A. G., & Krishnananthan, T. (2020) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000001938 · Cited by 3 · see citing works
Faecal microbiota transplantation associated adverse events
Patryn, R. K., Kaźmierczak-Wojtaś, N., Bułaś, L., Boretska, O., Szkultecka-Dębek, M., Drozd, M., & Blicharski, T. (2024) · Current Issues in Pharmacy and Medical Sciences · doi:10.2478/cipms-2024-0028 · Cited by 2 · see citing works
Ткач, С. М., Dorofeyev, A., Kuzenko, I., Boyko, N., Falalyeyeva, T. M., & Kobyliak, N. M. (2023) · Advances in predictive, preventive and personalised medicine · doi:10.1007/978-3-031-19564-8_10 · Cited by 2 · see citing works
Aidarova, A., Carels, M., Haegman, M., Driege, Y., Timmermans, S., Damme, E. V., Aguilera‐Lizarraga, J., Viola, M. F., Collaço, R. D. C., Manils, J., et al. (2025) · EMBO Molecular Medicine · doi:10.1038/s44321-025-00321-4 · Cited by 1 · see citing works
“Moreover, fecal microbiota transplantation was shown to improve colonic transit and defecation frequency of patients affected by constipation (Reigstad et al, 2015; Zhao and Yu 2016; Tian et al, 2017; Ge et al, 2017b; Zhang et al, 2018; Ding et al, 2018).”
Microbiota intestinal y estreñimiento. Una puesta al día
Hanna-Jairala, I., & Bustos-Fernández, L. M. (2020) · NeuroGastroLATAM Reviews · doi:10.24875/ngl.20000011 · Cited by 1 · see citing works
CE: Current and Emerging Applications of Fecal Microbiota Transplantation
Baker, K. A., & Poole, C. (2023) · AJN American Journal of Nursing · doi:10.1097/01.naj.0000978920.88346.77 · Cited by 1 · see citing works
Mikrobiota und Reizdarmsyndrom – eine kritische Bestandsaufnahme
Enck, P., & Mazurak, N. (2019) · Zeitschrift für Gastroenterologie · doi:10.1055/a-0901-2558 · Cited by 1 · see citing works
“Bislang ist der Beweis dafür, dass dies bei anderen Erkrankungen als der CDI wirksam ist, jedoch ausgeblieben; die Belege bei Morbus Crohn und Colitis ulcerosa sind enttäuschend [41], die bei funktionellen Störungen ebenfalls [42, 43], beim Reizdarmsyndrom ist die Methode teilweise sogar kontraindiziert (s.”
BackgroundPossible factors determining efficacy of fecal microbiota transplantation. Review
Ткач, С. М., Kharchenko, N. V., & Dorofeev, A. E. (2022) · Modern Gastroenterology · doi:10.30978/mg-2022-1-48
Концепция супердонора и другие возможные факторы эффективности трансплантации фекальной микробиоты
Ткач, С. М., Dorofeev, A. E., & Kuzenko, Y. G. (2020) · GASTROENTEROLOGY · doi:10.22141/2308-2097.54.3.2020.211740
Schmulson, M. J., & Saps, M. (2021) · NeuroGastroLATAM Reviews · doi:10.24875/ngl.m20000018
Yokoo, T., Takeda, M., Ishida, T., Koizumi, A., Kimura, K., Asami, Y., & Hatano, M. (2020) · Japanese Journal of Lactic Acid Bacteria · doi:10.4109/jslab.31.99
Fecal Microbiota Transplantation for Microbiome Modulation: A Clinical View
Konturek, P. C., Hess, T., Dieterich, W., & Zopf, Y. (2022) · Wiley eBooks · doi:10.1002/9783527825462.ch8
(2022) · International Journal of Traditional and Complementary Medicine · doi:10.28933/ijtcm-2022-02-2005
Pathophysiology, diagnostics and treatment of slow-transit constipation: a review
Garmanova, T., Рафаэлевич, М. Д., Lukianov, А. M., Kazachenko, E. A., Uhanov, P. G., & Bekova, Z. M. (2024) · Surgical practice (Russia) · doi:10.5922/2223-2427-2024-9-4-5
Targeting Gut Microbiota in the Management of Functional Constipation: A Narrative Review
Takeda, T., Hojo, M., Asaoka, D., & Nagahara, A. (2025) · Internal Medicine · doi:10.2169/internalmedicine.6457-25
Luo, D., Li, W., Zhang, C., Zhang, Z., & Ni, S.-Q. (2026) · Journal of food biochemistry · doi:10.1155/jfbc/2809212
Diagnosis and treatment of slow-transit constipation
Yang, F., & Tao, Q. (2026) · BMC Gastroenterology · doi:10.1186/s12876-026-04784-8
“However, it is difficult to compare the additional benefits of adding soluble dietary treatment with the author’s separate long-term follow-up study of FMT due to the use of different improvement scoring criteria [75].”
Chen, Y., Duan, W., Du, M., Guo, M., & Sun, Y. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2026.1817279
“In a prospective study of 52 patients with STC who received FMT and were followed for 6 months, no treatment-related severe adverse events were reported, and most adverse events were self-limiting gastrointestinal symptoms (Ding et al., 2018).”
Zhu, J., Zeng, B., Zhu, W., Liu, Y., Li, X., Zhang, Y., Xu, Z., Xu, Q., Wu, W., Li, J., et al. (2026) · iScience · doi:10.1016/j.isci.2026.117850
- Authors
- Ding, C., Fan, W., Gu, L., Tian, H., Ge, X., Gong, J., Nie, Y., & Li, N.
- Affiliations
- Nanjing General Hospital of Nanjing Military Command (CN)
- Xuzhou Medical College (CN)
- Xijing Hospital (CN)
- Tongji University (CN)
- Corresponding author
- Li, Ning
- Venue
- Gastroenterology report
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-11-08
- Volume
- 6
- Issue
- 2
- Pages
- 101-107
- ISSN
- 2052-0034 (ISSN-L)
- PMC
- PMC5952918
- OpenAlex
- W2767589553
- Cited by
- 65
- References
- 34
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 9 · 2019: 17 · 2018: 1
- FWCI
- 7.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Gastroenterology report (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81670493)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- fecal microbiota transplantation, slow transit constipation, gut microbiota, colonic motility, colonic transit time, incomplete evacuation, quality of life, treatment satisfaction, loss of efficacy, prognostic factors, long-term follow-up
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