The improvement effects of fecal microbiota transplantation on intestinal function, immune function and inflammation response in patients with refractory constipation

[Objectives] To investigate the improvement effects of fecal microbiota transplantation (FMT) on intestinal function, immune function, and inflammatory response in patients with refractory constipation. [Methods] Fifty-six patients with refractory constipation who visited the Department of Proctology of the First Affiliated Hospital of Xinjiang Medical University from March 2022 to March 2023 were enrolled and randomly divided into a control group (receiving conventional drug therapy, n＝28) and an observation group (receiving FMT in addition to conventional drug therapy, n＝28). The symptom scores, clinical efficacy, adverse reactions, microbial community values (including Yeast, Bifidobacteria, Lactobacilli, Escherichia coli, Enterococcus, Bacteroides, Clostridium, and the B/E ratio), intestinal function indicators (vasoactive intestinal peptide, somatostatin, and motilin), immune function indicators (interferon-γ and interleukin-4), and inflammatory response indicators (interleukin-6 and tumor necrosis factor-α) were compared between the two groups before and one month after treatment. [Results] One month after treatment, the symptom scores in both groups were lower than those before treatment, with the observation group showing significantly lower scores compared to the control group (P<0.05). The total clinical effective rate was 71.43% in the control group and 92.86% in the observation group, with a statistically significant difference (P<0.05). No serious adverse reactions occurred in either group. In the observation group, the microbial community values of yeast, bifidobacteria, and lactobacilli increased, while those of Escherichia coli, Enterococcus, Bacteroides, and Clostridium decreased, and the B/E ratio increased significantly compared to before treatment (P<0.05). There were no significant changes in the microbial community values or B/E ratio in the control group (P>0.05). Before treatment, there were no significant differences in the microbial community values or B/E ratio between the two groups (P>0.05). One month after treatment, the microbial community values of Yeast, Bifidobacteria, and Lactobacilli were higher, while those of Escherichia coli, Enterococcus, Bacteroides, and Clostridium were lower, and the B/E ratio was higher in the observation group compared to the control group, with statistically significant differences (P<0.05). After treatment, the levels of serum vasoactive intestinal peptide, somatostatin, motilin, interferon-γ, and interleukin-4 increased in both groups compared to before treatment, with significantly higher levels in the observation group (P<0.05). The levels of serum interleukin-6 and tumor necrosis factor-α decreased in both groups after treatment, with significantly lower levels in the observation group (P<0.05). [Conclusion] Fecal microbiota transplantation has good improvement effects on intestinal function, immune function, and inflammatory response in patients with refractory constipation. It can improve the structure of the microbiota and has good safety.