Study on the Efficacy and Safety of Fecal Microbiota Transplantation (FMT) in the Treatment of Functional Gastrointestinal Disorders
This study is designed to explore the efficacy and safety of fecal microbiota transplantation (FMT) with different delivery routes for patients with functional gastrointestinal disorders (FGIDs). The response to FMT varies greatly, which is related to donor selection, administration route, individual patient characteristics and microbiota compatibility. This single-center, prospective randomized controlled trial plans to enroll 200 FGID patients refractory to conventional medications from OCT 2026 to OCT 2029. Eligible participants will be randomized into a conventional medication group or an FMT group; the FMT group will be further randomized into three subgroups according to transplantation routes: oral capsule, nasojejunal tube and colonoscopic administration. Clinical data, laboratory, imaging and endoscopic results will be collected. Gut microbiota and metabolites will be analyzed before and after treatment. Clinical efficacy and safety will be evaluated at week 12.
Studieoversigt
Status
Betingelser
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: Yanyun Fan, PhD
- Telefonnummer: +86 592 2291429
- E-mail: fanyanyun@xmu.edu.cn
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
-
1: Aged 1865 years, regardless of gender;
2: Meeting the Rome IV diagnostic criteria (independently confirmed by two physicians with associate-senior title or above), including subtypes of irritable bowel syndrome: IBS-D (diarrhea-predominant), IBS-C (constipation-predominant), and IBS-M (mixed-type).
3: Patients with functional constipation (excluding defecatory disorder-related constipation), functional diarrhea, or functional bloating, who have poor response to or intolerance of at least one conventional pharmacotherapy (e.g., antispasmodics, antidiarrheals, osmotic laxatives), with a disease duration of ≥6 months.
4: Voluntarily participating in this study, signing a written informed consent form, and committing to comply with the study protocol.
Exclusion Criteria:
-
1: History of prior colectomy or planned surgery within 6 months
2: contraindications to colonoscopy (severe luminal stenosis, toxic megacolon, risk of perforation, etc.)
3: comorbid diagnoses: uncontrolled infectious enteritis, positive Clostridioides difficile test, intestinal ischemia, radiation colitis, active diverticular disease
4: ast or present history of active tuberculosis, active hepatitis B / hepatitis C / HIV infection opportunistic infections
5: severe systemic diseases: decompensated liver cirrhosis, NYHA Class Ⅲ-Ⅳ heart failure, renal insufficiency (eGFR<30 ml/min)
6: concomitant malignant tumor or lymphoma
7: severe immunodeficiency or long-term use of immunosuppressants or systemic glucocorticoids.
8: Pregnancy, lactation, or planned pregnancy within 6 months
9: allergy to FMT or study-related medications (laxatives, PPIs, etc.);
10: poor compliance, psychiatric disorders,or any other conditions deemed by investigators to render the subject unsuitable for participation in the study.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Oral capsule FMT group
Fecal microbiota transplantation via oral capsule combined with conventional symptomatic treatment for functional gastrointestinal disorders. |
FMT prepared from screened donor stool, administered by oral capsules, combined with conventional symptomatic treatment. |
|
Eksperimentel: Nasojejunal tube FMT group
Fecal microbiota transplantation delivered through nasojejunal tube combined with conventional symptomatic treatment for functional gastrointestinal disorders. |
FMT prepared from screened donor stool, infused via nasojejunal tube, combined with conventional symptomatic treatment. |
|
Eksperimentel: Colonoscopic FMT group
Fecal microbiota transplantation administered by colonoscopic catheter combined with conventional symptomatic treatment for functional gastrointestinal disorders. |
FMT prepared from screened donor stool, delivered through colonoscopic catheter, combined with conventional symptomatic treatment. |
|
Aktiv komparator: Conventional medication group
Routine symptomatic drug treatment for functional gastrointestinal disorders without fecal microbiota transplantation. |
Routine symptomatic drugs for functional gastrointestinal disorders, without fecal microbiota transplantation. |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Clinical response rate at week 12
Tidsramme: 12 weeks after enrollment
|
The proportion of participants achieving clinical response (≥50% reduction in symptom score). Compare treatment responses across FGID subtypes (IBS-C, IBS-D, mixed IBS, functional constipation, functional diarrhea, functional bloating), and compare efficacy among three FMT administration routes. |
12 weeks after enrollment
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Adverse events of FMT
Tidsramme: From FMT initiation to week 12
|
The type, frequency and severity of adverse events during transplantation, within 4 weeks (short-term) and within 12 weeks (long-term) after transplantation; compare route-related safety risks. |
From FMT initiation to week 12
|
|
Change in quality of life assessed by the Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire
Tidsramme: Baseline, week 12
|
The Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, ranging from 0 to 100. Higher scores indicate worse quality of life. Assessments will be performed at baseline and week 12. |
Baseline, week 12
|
|
Change in gut microbial alpha-diversity
Tidsramme: Baseline, week 12
|
Gut microbial alpha-diversity (e.g., Shannon index, Chao1 index). Fecal samples will be collected for 16S rRNA sequencing. |
Baseline, week 12
|
|
Change in quality of life assessed by the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire
Tidsramme: Baseline, week 12
|
The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, ranging from 0 to 112. Higher scores indicate worse quality of life. Assessments will be performed at baseline and week 12. |
Baseline, week 12
|
|
Change in gut microbial beta-diversity
Tidsramme: Baseline, week 12
|
Gut microbial beta-diversity, reflecting overall dissimilarity of microbial community composition. Fecal samples will be collected for 16S rRNA sequencing. |
Baseline, week 12
|
|
Changes in relative abundance of beneficial taxa and microbiota engraftment
Tidsramme: Baseline, week 12
|
Relative abundance of beneficial bacterial taxa and the degree of microbiota engraftment toward donor microbial profiles. Fecal samples will be collected for 16S rRNA sequencing. |
Baseline, week 12
|
Samarbejdspartnere og efterforskere
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- MR-35-26-081205
Plan for individuelle deltagerdata (IPD)
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