The purpose of this study is to evaluate the effect and safety of pectin and fecal microbiota transplantation on patients with inflammatory bowel disease. The investigators hypothesize that patients who take pectin can promote the migration of probiotics in intestine engraftment, reduce pathogenic agents'adhesion to intestinal mucosa, cut down the inflammation, and to maintain intestinal flora diversity and steady state in a long time.
Inflammatory bowel disease (IBD) is a chronic relapsing disease, including ulcerative colitis (UC) and Crohn's disease (CD). Although the etiology of IBD is unknown, but more and more evidence show that the inappropriate immune response to intestinal commensal bacteria leading to dysbiosis, and pathogens further act to the mucosal lymphoid tissue, causing IBD. Has yet not to determine the specific one or more pathogens as the cause of IBD,but literatures confirm the changes of diversity of the intestine flora.Based on the current awareness of changes in the intestinal flora in IBD, fecal microbiota transplantation (FMT) proposed in recent years to rebuild the intestine flora balance to achieve therapeutic purposes. But fecal bacteria of patients can not consistent with donor's for a long term after transplantation and therefore it is not an ideal way for disease control. Maintaining the diversity of flora in a long time so that well controlled the disease become the breakthrough of fecal microbiota transplantation in the treatment of inflammatory bowel disease. Pectin is a soluble dietary fiber (DF), produced by the gut flora after a series of fermentation with many metabolites such as short chain fatty acids (SCFA) which supply the energy for epithelial cells, regulate intestinal PH and intestinal motility and join effort in immune regulation with intestinal lymphoid tissue. Previous studies showed that: water-soluble dietary fiber with the action of intestinal flora can cut the inflammatory cytokines, prevent inflammation and induce regulatory T cells, but the type and dose of dietary fiber used were different in different studies, and no studies have confirmed whether dietary fiber could adjusted the flora colonization ability in patients with IBD. We conceive that pectin by some mechanism to promote the migration of probiotics in intestine engraftment, reduce pathogenic agents' adhesion of intestinal mucosa, cut inflammation, and to maintain intestinal flora diversity and steady state in a long time, and than achieve the goal of continue to ease IBD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
300ml Bacterial suspension (from 60g fresh stool )for fecal microbiota transplantation the first day and 20g pectin given continuously for total five days
single fecal microbiota transplantation once the first day
pure give pectin 20g/d for five days
Department of General Surgery, Jinling hosptal,Medical School of Nanjing University
Nanjing, Jiangsu, China
RECRUITINGdiversity and steady state of the stool
Change from Baseline in diversity and steady state of the stool every week within one month after the intervention and three and six months after intervention
Time frame: 6 months
Erythrocyte sedimentation rate
Change from Baseline in ESR 1st,3st,6st month after intervention
Time frame: 6 months
C-reactive protein
Change from Baseline in CRP 1st,3st,6st month after intervention
Time frame: 6 months
Fecal calcium protein
Change from Baseline in Fecal calcium protein 1st,3st,6st month after intervention
Time frame: 6 months
Adverse reactions after fecal microbiota transplantation and/or take pectin
every day within one week after the intervention
Time frame: 1 week
Crohn's disease activity index
Change from Baseline in CDAI two weeks,one,three and six months after intervention
Time frame: 6 months
Ulcerative Colitis disease activity index
Change from Baseline in UCDAItwo weeks,one,three and six months after intervention
Time frame: 6 months
the simple endoscopic score for CD
Change from Baseline in SEC-CD 3st,6st months after intervention
Time frame: 6 months
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Ulcerative Colitis endoscopic index of severity
Change from Baseline in UCDEIS 3st and 6st month after intervention
Time frame: 6 months
diversity and steady state of the Intestinal mucosa
Change from Baseline in diversity and steady state of the intestinal mucosa three and six months after intervention
Time frame: 6 months