Awareness and attitude of fecal microbiota transplantation through transendoscopic enteral tubing among inflammatory bowel disease patients

Abstract

BACKGROUND Transendoscopic enteral tubing (TET) has been used in China as a novel delivery route for fecal microbiota transplantation (FMT) into the whole colon with a high degree of patient satisfaction among adults. AIM To explore the recognition and attitudes of FMT through TET in patients with inflammatory bowel disease (IBD). METHODS An anonymous questionnaire, evaluating their awareness and attitudes toward FMT and TET was distributed among IBD patients in two provinces of Eastern and Southwestern China. Question formats included single-choice questions, multiple-choice questions and sorting questions. Patients who had not undergone FMT were mainly investigated for their cognition and acceptance of FMT and TET. Patients who had experience of FMT, the way they underwent FMT and acceptance of TET were the main interest. Then all the patients were asked whether they would recommend FMT and TET. This study also analyzed the preference of FMT delivery in IBD patients and the patient-related factors associated with it. RESULTS A total of 620 eligible questionnaires were included in the analysis. The survey showed that 44.6% (228/511) of patients did not know that FMT is a therapeutic option in IBD, and 80.6% (412/511) of them did not know the concept of TET. More than half (63.2%, 323/511) of the participants stated that they would agree to undergo FMT through TET. Of the patients who underwent FMT via TET [62.4% (68/109)], the majority [95.6% (65/68)] of them were satisfied with TET. Patients who had undergone FMT and TET were more likely to recommend FMT than patients who had not (94.5% vs 86.3%, P = 0.018 and 98.5% vs 87.8%, P = 0.017). Patients’ choice for the delivery way of FMT would be affected by the type of disease and whether the patient had the experience of FMT. When compared to patients without experience of FMT, Crohn’s disease and ulcerative colitis patients who had experience of FMT preferred mid-gut TET ( P < 0.001) and colonic TET ( P < 0.001), respectively. CONCLUSION Patients’ experience of FMT through TET lead them to maintain a positive attitude towards FMT. The present findings highlighted the significance of patient education on FMT and TET.

Low acceptance of illness with inflammatory bowel disease tending to receive fecal microbiota transplantation

“…Our study showed that IBD patients were interested in FMT but low awareness and acceptance, which is consistent with the results of domestic and international studies [22][23][24].The most preferred route for patients to receive FMT treatment in this study was oral fecal capsules (50.97%), which may be related to convenience and good tolerability [25]. However, anesthesia colonoscopy was preferred by 77% of UC patients in Kahn 's study [26] and 49.7% of CD patients in Zeitz's study [27].…”

“…Drug infusion is facilitated by colonoscopy while minimizing psychological discomfort, but bowel preparation can be found unbearable by some patients [28]. The Transendoscopic enteral tubing(TET) route has also been proposed as a solution to the limitations of repeated FMT in a short period of time, avoiding intestinal injury and bleeding caused by repeated insertion of enema tubes or colonoscopy [23,29]. Nevertheless, only 5.81% of patients in our study chose the TET, due to the low awareness of TET in patients with IBD .…”

Fecal Microbiota Transplantation as Therapy for Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis

“…With regard to the lower gastrointestinal route of FMT administration, the latest progress is colonic TET, which is a safe, convenient, and reliable procedure for FMT that results in a high degree of patient satisfaction [ 22 , 23 ]. The experience of FMT through TET of patients with IBD leads them to maintain a positive attitude towards FMT [ 24 ]. Therefore, FMT delivery methods need to be rationally designed taking into account efficacy and recipient factors.…”

Encyclopedia of fecal microbiota transplantation: a review of effectiveness in the treatment of 85 diseases

“…It was proven to be a safe and convenient procedure for multiple FMTs and colonic medication administration for patients aged over 7 years old [136] . According to a survey, patients who had undergone FMT by TET were more likely to recommend FMT than patients who had not [137] . Zhong et al [138] also reported that colonic TET was a safe and convenient delivery method in children aged 3–7 years.…”

“…[136] According to a survey, patients who had undergone FMT by TET were more likely to recommend FMT than patients who had not. [137] Zhong et al [138] also reported that colonic TET was a safe and convenient delivery method in children aged 3-7 years.…”