Ulcerative colitis, male in his 30s -Fecal microflora transplant case report
Case presentation: Male in his 30s, ulcerative colitis
summary
He has had recurrent diarrhea and abdominal pain since childhood. In 1993, he underwent a thorough examination for the same symptoms. He was diagnosed with ulcerative colitis, irritable bowel syndrome, and depression, and was treated with gastrointestinal drugs, anti-inflammatory drugs, and depression medication. Currently, she is not taking any medications. This time, he underwent fecal transplantation with saline solution and ultrafine bubble solution. The patient started with the saline solution. The patient temporarily developed diarrhea from soft stools. Next, the functional water solution for transplantation was administered three times. The stools became solid, and the symptoms improved from before the fecal transplantation.Basic Information
| Patients : | Male in his 30s |
| Attending physician : | Luke’s Ashiya Clinic |
| Medical institution in charge of transplantation : | Luke’s Ashiya Clinic |
Information at the time of initial medical examination
| Disease name : | Irritable bowel syndrome, suspected ulcerative colitis, depression |
| At onset | Unknown (since childhood) |
| Transplant Purpose: To | diarrhea |
| Chief complaint : | Diarrhea, abdominal pain, stomach upset, depression, daytime sleepiness |
| Medications being taken : | Nothing |
| Medical history : | Suspected ulcerative colitis, irritable bowel syndrome, depression |
| Background, family history, lifestyle, supplement use, etc : | Around 1993, he was diagnosed at a university hospital and clinic for pre-existing symptoms (ulcerative colitis, irritable bowel syndrome, and depression) and was treated with gastrointestinal medications, anti-inflammatory medications, and depression medications. Currently, he is not taking any medications. Family history: bile duct cancer, 1/2 stomach removed (father). |
Transplant Information
| Transplantation period: from | January 17, 2018 – February 24, 2019 |
| Number of transplants : | 1 time saline solution + 3 times ultra fine bubble water |
| Change from first transplant to end of transplant : |
| Post-transplant interview after the first transplant:
saline solution. Previous colonoscopy showed inflammation but did not confirm ulcerative colitis. He has also been diagnosed with irritable bowel syndrome. Also, secondary depressive symptoms have been observed in the past.
Interview at the time of the 2nd transplant: Ultra Fine Bubble Water On the third day after the first transplant, he began to have diarrhea from soft stools. Interview at the time of the 3rd transplant: Ultra Fine Bubble Water After the 2nd transplant, diarrhea continued, but changed to solid stools 2~3 days ago. Fourth interview: After the third transplant, I feel that various symptoms have improved from before the transplant. |
| Changes after completion of transplant : |
| Diarrhea admits resolution. |
Evaluation and Discussion
| Transplant Evaluation : | Moderate improvement of symptoms |
| Pre- and post-transplant flora balance test changes:. | [Before transplantation] January 2018.
The intestinal flora suggests that the patient is overly attentive to details and nervousness.
The balance is reminiscent of a Western style of eating, but may also show a similar balance due to supplements and medications in addition to diet.
[Transplanting] Conducted in January 2018. I would like to refrain from discussing the university method because of the unpredictable behavior of the activity that conventional bacteria have. [Transplanting in progress] February 2018. I assume that the transplantation of the Shimizu method has allowed the bacteria to grow in their natural territory. Now, if the ratio of Probotella and Bacteroides could be reduced a little more, Clostridium genus could be reduced with the same ratio, and the ratio of Lactobacillus bifidus could be increased, further improvement of symptoms is expected. [Transplanting in progress] February 2018. Almost the same comments as the third result. [Post-transplant] March 2018. Nutritional guidance seems to be working. Mental status appears to be leaning rather slightly positive. Further improvement of the balance by opportunistic bacteria is expected to continue. |
| Blood test changes:. | No data |
| POMS2 SCORE CHANGE:. | There is improvement in depression, tension, and liveliness. |
| His/her experience (from the questionnaire) : |
| No reply |
| Adverse events: No |
| Nothing |
| Transplant General Comments and Discussion : |
| IN FMT WITH SALINE SOLUTION FOR IRRITABLE BOWEL SYNDROME AND ULCERATIVE COLITIS (SUSPECTED), DIARRHEA AND SOFT STOOLS WERE OBSERVED AFTER TRANSPLANTATION, BUT GRADUALLY CHANGED TO SOLID STOOLS IN FMT WITH ULTRAFINE BUBBLE WATER PERFORMED THREE TIMES AFTERWARD. DEPRESSIVE TENDENCY WAS ALSO IMPROVED BY POMS. ALTHOUGH THE CAUSAL RELATIONSHIP BETWEEN THE DIARRHEA AND SOFT STOOL AFTER ONLY ONE FMT SESSION WITH SALINE SOLUTION IS NOT CLEAR, THE SYMPTOMS TENDED TO IMPROVE AFTER ALL FOUR SESSIONS. FMT IS THOUGHT TO BE EFFECTIVE IN IMPROVING IBS AND OTHER SYMPTOMS. |
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