Department of Gastrointestinal Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Int J Colorectal Dis. 2020 Oct;35(10):1955-1958. doi: 10.1007/s00384-020-03648-1. Epub 2020 Jun 5.
The gut microbiota is conceivably a key factor in the aetiology of pouchitis. Faecal microbiota transplantation (FMT) has been suggested as a promising new treatment for chronic pouchitis, where treatment options often are few. However, little is known about the influence of the diet on the clinical effects of FMT. We assessed the diet of patients with chronic pouchitis undergoing FMT to investigate the influence of diet on the clinical outcome after FMT.
Nine patients with chronic pouchitis were allocated to treatment with FMT delivered by enema from five faecal donors for 14 consecutive days in a 6-month prospective, open-label, single-centre cohort pilot study. A dietary questionnaire was completed at baseline for all patients and donors. Patients underwent a pouchoscopy at baseline and at 30-day follow-up, and the Pouchitis Disease Activity Index (PDAI) was assessed.
Patients' diets were generally similar, when comparing patients in remission post-FMT (PDAI < 7) with those who relapsed (PDAI ≥ 7). Consumption of grains trended to be different between the two groups (p = 0.06), where patients in relapse consumed more bread products than did patients in remission. However, consumption of yoghurt was significantly different between the two groups (p = 0.04), with patients in remission consuming more yoghurt (mean 1.1 s/d vs 0.2 s/d).
Gastroenterologist performing clinical studies on FMT for chronic pouchitis should be aware of dietary habits as contributing factors for the clinical effect of FMT.
肠道微生物群可能是 pouchitis 发病机制中的关键因素。粪便微生物群移植（FMT）已被提议作为慢性 pouchitis 的一种有前途的新治疗方法，因为慢性 pouchitis 的治疗选择通常很少。然而，对于饮食对 FMT 临床效果的影响知之甚少。我们评估了接受 FMT 的慢性 pouchitis 患者的饮食，以研究饮食对 FMT 后临床结果的影响。
在一项为期 6 个月的前瞻性、开放标签、单中心队列试点研究中，9 名慢性 pouchitis 患者被分配接受来自 5 名粪便供体的灌肠 FMT，连续 14 天。所有患者和供体在基线时完成了饮食问卷。患者在基线和 30 天随访时进行了 pouchoscopy，并评估了 pouchitis 疾病活动指数（PDAI）。
比较 FMT 后缓解（PDAI<7）和复发（PDAI≥7）的患者，患者的饮食总体相似。两组之间谷物的消耗趋势不同（p=0.06），复发组患者消耗更多的面包产品，而缓解组患者消耗更多的酸奶（p=0.04）。
进行慢性 pouchitis 的 FMT 临床研究的胃肠病学家应意识到饮食习惯是 FMT 临床效果的促成因素。
