Title: Colonic distribution of FMT by different enema procedures compared to colonoscopy –
proof of concept study using contrast fluid
Version: 3 Date: 25 Jul 2023
Reviewer's report:
Dr.Skjevling and coworkers present a practically very important study about the potential
for simplifying faecal microbiota transplantation (FMT) by administering the transplant by
enema. The maximum proximal extension of diluted barium contrast was used as an indication,
of successful transplantation. The conclusion is that enema could be adequate, although the
importance of the transplant reaching the ascending colon, or even the small bowels when
administered by gastroscopy is not discussed. The study was well planned, performed and
presented. I have a few questions still:
1. Was a pilot study performed to guide the optimal timing of abdominal x-rays after positioning
maneuvres?
2. Would it be possible to repeat the abdominal x-ray after a suitable time to look at drainage of
contrast, to indicate the retension of a faecal transplant?
3. It is suggested that the procedure could be performed by nurses. Was the enema administred
by a radiologist or other specially trained person?
4. In Results, page 7, it is stated that 31 participants (patients) were screened for eligibility. How
many were in fact eligible, were offered participation, and what were the main reasons for not
being included?
Title: Colonic distribution of FMT by different enema procedures compared to colonoscopy –
proof of concept study using contrast fluid
Version: 3 Date: 25 Jul 2023
Reviewer's report:
Dr.Skjevling and coworkers present a practically very important study about the potential
for simplifying faecal microbiota transplantation (FMT) by administering the transplant by
enema. The maximum proximal extension of diluted barium contrast was used as an indication,
of successful transplantation. The conclusion is that enema could be adequate, although the
importance of the transplant reaching the ascending colon, or even the small bowels when
administered by gastroscopy is not discussed. The study was well planned, performed and
presented. I have a few questions still:
1. Was a pilot study performed to guide the optimal timing of abdominal x-rays after positioning
maneuvres?
2. Would it be possible to repeat the abdominal x-ray after a suitable time to look at drainage of
contrast, to indicate the retension of a faecal transplant?
3. It is suggested that the procedure could be performed by nurses. Was the enema administred
by a radiologist or other specially trained person?
4. In Results, page 7, it is stated that 31 participants (patients) were screened for eligibility. How
many were in fact eligible, were offered participation, and what were the main reasons for not
being included?
Please review this paper.
user
Title: Colonic distribution of FMT by different enema procedures compared to colonoscopy –
proof of concept study using contrast fluid
Version: 3 Date: 25 Jul 2023
Reviewer's report:
Dr.Skjevling and coworkers present a practically very important study about the potential
for simplifying faecal microbiota transplantation (FMT) by administering the transplant by
enema. The maximum proximal extension of diluted barium contrast was used as an indication,
of successful transplantation. The conclusion is that enema could be adequate, although the
importance of the transplant reaching the ascending colon, or even the small bowels when
administered by gastroscopy is not discussed. The study was well planned, performed and
presented. I have a few questions still:
1. Was a pilot study performed to guide the optimal timing of abdominal x-rays after positioning
maneuvres?
2. Would it be possible to repeat the abdominal x-ray after a suitable time to look at drainage of
contrast, to indicate the retension of a faecal transplant?
3. It is suggested that the procedure could be performed by nurses. Was the enema administred
by a radiologist or other specially trained person?
4. In Results, page 7, it is stated that 31 participants (patients) were screened for eligibility. How
many were in fact eligible, were offered participation, and what were the main reasons for not
being included?
assistant