2. Materials and Methods
3.1. Survey Results
3.2. Focus Group Results
Conflicts of Interest
Appendix A. AFFINITY Questionnaire
- Questions about your surgery and symptoms
- Which of these best describes your surgery?
- Currently have ileostomy/stoma ☐
- Had ileostomy/stoma but now reversed☐
- Never had ileostomy/stoma ☐
- LARS Score
- Do you ever have occasions when you cannot control you flatus (wind)?
- No, never☐ (0)
- Yes, less than once per week ☐(4)
- Yes, at least once per week ☐(7)
- Do you ever have any accidental leakage of liquid stool?
- No, never☐ (0)
- Yes, less than once per week ☐ (3)
- Yes, at least once per week ☐ (3)
- How often do you open your bowels?
- More than 7 times per day (24 h) ☐ (4)
- 4–7 times per day (24 h) ☐ (2)
- 1–3 times per day (24 h) ☐ (0)
- Less than once per day (24 h) ☐ (5)
- Do you ever have to open your bowels again within one hour of the last bowel opening?
- No, never☐ (0)
- Yes, less than once per week ☐ (9)
- Yes, at least once per week ☐ (11)
- Do you ever have such a strong urge to open your bowels that you have to rush to the toilet?
- No, never☐ (0)
- Yes, less than once per week ☐ (11)
- Yes, at least once per week ☐ (16)
- Have you had treatment for symptoms of low anterior resection syndrome/LARS?
- Yes ☐ No ☐ Don’t know ☐
- If your answers suggest you may benefit for treatment for low anterior resection syndrome/LARS, would you be happy for us to contact your GP/local colorectal team?
- Yes ☐ No ☐
- Faecal Microbiota Transplantation (FMT) is putting bacteria from someone else’s faeces (poo) into the bowel. It is a recognized treatment for some bowel infections. It works by increasing the healthy bacteria in the bowel. Some people who have surgery for rectal cancer have altered bowel function after their ileostomy (stoma) is reversed. We think this may be caused by a lack of healthy bacteria in the bowel. This could be improved by FMT. The faeces from a healthy donor is mixed with saline (salt water) and would be inserted through the ileostomy before surgery to close it.
- We want to know whether this sounds like an acceptable treatment to you.
- For each statement please tick the box which fits most with your opinion.
|Not at all||A Little||Some-what||Quite a bit||Very Much|
|FMT seems like an appropriate way to prevent symptoms of LARS|
|FMT would fit my individual lifestyle|
|FMT seems like an effective way to prevent LARS|
|I would be willing to try FMT|
- Which of these would be an acceptable FMT donor? (tick all that apply)
- Partner/spouse ☐
- Blood relative ☐
- Friend ☐
- Anonymous healthy donor ☐
- None of above ☐
- Which of these routes for giving FMT is acceptable?
- Via the ileostomy/stoma ☐
- Via the rectum (bottom)/enema ☐
- Via colonoscopy (magic eye/camera test) ☐
- None of above ☐
- Questions about you
- What is your age? ………..
- What is your gender?
- Male ☐ Female ☐ Other ☐
- How would you describe your ethnic origin?
- Asian or Asian British☐ Black or Black British ☐ Mixed ☐
- White British ☐ Other ethnic group☐ Please write in ………………
- Are you…?
- Single ☐ Married/civil partnership ☐ Widowed ☐
- Co-habiting ☐ Separated/divorced ☐
- What is your level of education?
- Degree or equivalent ☐ A Level or equivalent ☐
- GCSEs or equivalent ☐ Other qualification ☐
- No qualification ☐
- Which of these activities best describes what you are doing at present?
- Employee in full time job☐ Employee in part time job☐
- Self-employed☐ Full time education☐
- Unemployed☐ Permanently sick/disabled ☐
- Retired☐ Looking after the home ☐
- Carer for spouse/relative ☐ Other ☐
- What is your current job or last job you did if not currently working?
- Had you heard of FMT before receiving this questionnaire?
- Yes- for clostridium difficile/infection ☐
- Yes- for ulcerative colitis/inflammatory bowel ☐
- No ☐
Appendix B. Focus Group Topic Guide
|Welcome and thank participants on arrival|
Introductions and purpose of the focus group
|The idea of FMT
|Participating in a trial
|Any other comments you would like to make?|
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n = 40 (%)
|Ethnicity||White British||38 (95)|
|Did not answer||2 (5)|
|Marital Status||Married/Civil Partnership||24 (60)|
|Did not answer||1 (2.5)|
|Level of education||Degree||8 (20)|
|A Level||5 (12.5)|
|No qualification||6 (15)|
|Did not answer||1 (2.5)|
|Employment||Employed full time||4 (10)|
|Employed part time||6 (15)|
|Full time education||1 (2.5)|
|LARS Score||Responses n = 29 (%)|
|0–20 (No LARS)||7 (24)|
|21–29 (Minor LARS)||7 (24)|
|30–42 (Major LARS)||15 (52)|
|Demographics||Willing to Try FMT|
Very Much/Quite a Bit
n = 18 (%)
|Not Willing to Try FMT|
A Little/not at all
n = 9 (%)
|Male||10 (56)||5 (56)|
|Median age (range)||69 (31–79)||73 (38–80)|
|Degree level education||5 (28)||1 (11)|
|No qualification||3 (17)||1 (11)|
|In work/education||10 (56)||3 (33)|
|Married/cohabiting||11 (61)||7 (78)|
|Previously heard of FMT||5 (28)||1 (11)|
|Have stoma||8 (44)||0 (0)|
|Major LARS||6 (33)||4 (44)|
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