Effect of Fecal microbiota transplantation on heart rate variability in patients with irritable bowel syndrome

Abstract

Background

Irritable bowel syndrome (IBS) is a condition with abdominal pain associated with altered bowel function. There is no effective treatment, and the condition has a big impact on quality of life. IBS has recently been redefined as a disorder in brain-gut interaction, also called autonomic dysfunction. Heart Rate Variability (HRV) is a non-invasive method that provides quantitative evaluation of sympatho-vagal interactions modulating cardiac function and is believed to give an indication of the autonomic state in the body. Fecal microbiota transplantation (FMT) involves transferring feces from a healthy donor to a recipient to address dysbiosis and restore gut microbiota balance. In relation to IBS, FMT is a relatively novel approach with mixed results and unclear outcomes. Our study explore the effect of FMT-treatment on autonomic function, represented with HRV-measurements, in IBS-patients. We also investigate if there is a significant increase in HRV in participants reporting improvement.

Method

Participants were recruited to this add-on study from the larger REFIT2. Eligible participants were randomized to receive a single fecal microbiota transplantation (FMT) from the donor-group or autologeous FMT. All FMTs were administered via enema, followed by a standardised positioning procedure. HRV was measured with a resting continuous ECG recording in 15 minutes, 8 days before and 90 days after treatment. IBS-SSS was answered 8 days before and 90 days after treatment.

Results

There was no significant change in HF-HRV (p = 0.865) or RMSSD-HRV (p=0,457) in response to FMT-treatment. Additionally, participants reporting of improved symptoms (N=38) had no association with improved HF-HRV (p = 0.862) or RMSSD-HRV (p = 0.794).

Conclusion

According to this study, FMT-treatment has no effect on autonomic dysfunction in IBS-patient