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

Min Zhong; Yang Sun; Hong-Gang Wang; Cicilia Marcella; Bo-Ta Cui; Ying-Lei Miao; Fa-Ming Zhang

doi:10.12998/wjcc.v8.i17.3786

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

World J Clin Cases. 2020 Sep 6;8(17):3786-3796. doi: 10.12998/wjcc.v8.i17.3786.

Authors

Min Zhong¹, Yang Sun², Hong-Gang Wang³, Cicilia Marcella¹, Bo-Ta Cui¹, Ying-Lei Miao², Fa-Ming Zhang¹

Affiliations

¹ Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
² Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Yunnan Institute of Digestive Disease, Kunming 650032, Yunnan, China.
³ Medical Center for Digestive Diseases, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China.

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.

Keywords: Attitude; Fecal microbiota transplant; Recognition; Transendoscopic enteral tubing; Washed microbiota transplantation.