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Background Diosmectite, a natural colloidal clay, has been used worldwide for a number of approved indications, including the treatment of chronic functional diarrhea. Here, we used high-resolution whole metagenome shotgun sequencing to assess the impact of a 5 weeks administration of diosmectite (3 g/sachet, 3 sachets/day) on the fecal microbiota of 35 adults with functional chronic diarrhea. Results Gut microbiota was not impacted by diosmectite administration. In particular, richness remained stable and no microbial species displayed a significant evolution. Segregating patients either by diosmectite response (non responder, early responder, late responder) or by nationality (Great-Britain or Netherlands) yielded the same results. Conclusion We concluded that no microbiota-related physiological alterations are expected upon long-term treatment with diosmectite. Trial registration Clinicaltrials.gov  NCT03045926

Long-term diosmectite use does not alter the gut microbiota in adults with chronic diarrhea