IDDF2023-ABS-0066 Washed microbiota transplantation: an integrated therapy of irritable bowel syndrome targeting both gastrointestinal and extraintestinal symptoms

Background

Washed microbiota transplantation (WMT) has been demonstrated as an effective treatment for IBS. However, limited research has assessed its efficacy in managing extraintestinal symptoms of IBS, particularly poor sleep and psychological disorders. This study aimed to evaluate the therapeutic effect of WMT on sleep disturbances, psychological and gastrointestinal symptoms among patients with IBS.

Methods

This is a prospective observational study involving patients with IBS who underwent WMT. The Gastrointestinal Symptom Rating Scale (GSRS) and IBS Severity Scoring System (IBS-SSS) were used to assess gastrointestinal symptoms and IBS severity, respectively. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. The Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) were used to evaluate depression and anxiety, respectively. All the questionnaires were evaluated at baseline and one month after WMT. A multiple logistic regression model was used to determine the predictive factors of sleep improvement.

Results

Seventy-three patients with IBS were included in the study. Sleep quality (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), gastrointestinal symptoms (P = 0.004), and IBS severity (P < 0.001) significantly improved one month after WMT in all patients. The five components of PSQI in patients with poor sleep quality (PSQI scores > 5 suggests poor sleep quality) decreased one month after WMT compared to baseline scores: subjective sleep quality (P = 0.001), sleep latency (P < 0.001), sleep duration (P = 0.008), habitual sleep efficiency (P < 0.001) and sleep disturbances (P < 0.001) (IDDF2023-ABS-0066 Figure 1. The change of PSQI component scores in patients with poor sleep quality. n = 52). Patients that experienced sleep improvement demonstrated greater alleviation in depression and IBS severity compared with patients without. Baseline PSQI scores were identified as an independent predictive factor of sleep improvement one month after WMT (OR 1.285 [95% CI = 1.004-1.643]; P = 0.046).

Conclusions

Our findings suggest that WMT may be a promising integrated therapy for IBS, improving both gastrointestinal and extraintestinal symptoms. Furthermore, WMT may produce better and more sustained clinical outcomes by improving the sleep of IBS patients.