Psychiatric comorbidities were significantly associated with the presence of gastrointestinal symptoms after successful fecal microbiota transplantation (FMT), according research presented at the American College of Gastroenterology (ACG) 2021 Annual Meeting, held from October 22 to 27, 2021, in Las Vegas, Nevada and virtually.

Researchers performed a retrospective cohort study of patients who were successfully treated for recurrent Clostridioides difficile infection (CDI) with FMT. Success was defined as the absence of diarrhea or negative CDI testing 8 weeks following FMT. Patient data regarding CDI and psychiatric history were collected and gastrointestinal symptoms such as abdominal pain, bloating, flatulence, loose stools, and constipation following FMT were assessed. Associations of psychiatric comorbidities with any gastrointestinal symptom was the primary outcome.

Overall, 158 patients were identified, 31 (20%) of whom had psychiatric comorbidities. These included anxiety (n=12), depression (n=11), bipolar disorder (n=1), post-traumatic stress disorder (n=2), or multiple diagnoses (n=5). Among patients with psychiatric comorbidities, 30 (96%) were prescribed psychotropic medication at the time of FMT, 25 (80.7%) were women, and the median age was 59 (interquartile range, 40-73) years.


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There were no significant differences in clinical factors between patients with and without psychiatric comorbidities. Compared against those without psychiatric comorbidities following FMT, patients with psychiatric comorbidities experienced higher rates of any gastrointestinal symptom (67.7% vs 44.1%; P =.02), abdominal pain (25.8% vs 4.7%; P <.001), and bloating (12.9% vs 3.2%; P =.03).

After adjusting for pre-existing irritable bowel syndrome and inflammatory bowel disease, any gastrointestinal symptoms (odds ratio [OR], 2.67; 95% CI, 1.14-6.28), or just abdominal pain (OR, 9.01; 95% CI, 2.48-32.71) following FMT were more likely in patients with psychiatric comorbidities.

Researchers concluded, “Patients should be assessed pre-FMT for [psychiatric comorbidities] so appropriate counseling can be performed.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Gupta S, McClure E, Marcus J, Chan W, Allegretti J. Comorbid psychiatric conditions are associated with increased risk of gastrointestinal symptoms following successful fecal microbiota transplantation for Clostridioides difficile infection. Presented at: ACG 2021 Annual Meeting; October 22-27, 2021; Las Vegas, NV and virtual. Abstract P1438.