Irritable bowel syndrome (diarrhea type) in a man in his 40s – Case report of fecal microbiota transplantation

July 31, 2019
irritable bowel syndromeMedical Corporation Yuuakai Kawai Internal Medicine ClinicVIDEO.

Case presentation: Male in his 40s, irritable bowel syndrome (diarrhea type)

summary

A case of diarrhea (irritable bowel syndrome) that began a year and a half ago and continued until he came to our hospital after learning about stool transplantation on the Internet.

Basic Information

Patients:.	40s Male
Attending physician:.	Kawai Internal Medicine Clinic
Medical institution in charge of transplantation:.	Kawai Internal Medicine Clinic

Information at the time of initial medical examination

Disease name:.	Irritable bowel syndrome (diarrhea type)
At onset	Around 42 years old
Transplant Purpose: To	Irritable Bowel Syndrome Treatment
Chief complaint:.	Irritable Bowel Syndrome Treatment
Medications being taken:.	Ilibo Mepenzotate Rohrazev Depas Hange Shacintu (Chinese herbal medicine)
Medical history	retinal detachment
Background, family history, lifestyle, supplement use, etc.:.	Mother (bladder cancer, high blood pressure, diabetes, heart disease), many supplements

Transplant Information

Transplantation period: from	May 29, 2018 – October 16, 2018
Number of transplants	9 times

Change from first transplant to end of transplant:.

【1st transplantation questionnaire】
Irritable bowel syndrome for a year. had been carb free for 2 years until about Feb. Diarrhea did not get better. I do muscle training every day.

【2nd transplantation questionnaire】
The day after transplant, I had a banana stool. Diarrhea when taking protein in the morning.

【3rd transplantation questionnaire】
Soft stools are continuing. No banana stools. Protein has been stopped.

【4th transplantation questionnaire】
Some days I have good stools. I drink cold-pressed juice in the morning. 1 day I was constipated and had hard stools. I have had diarrhea for a long time, so I don’t take any dairy products. I can eat one egg a day, but if I eat two eggs a day, I get diarrhea. Eats pasta at night.

【5th transplantation questionnaire】
She seems to be doing well and is having mostly banana stools. He used to need to take Depas when entering a closed space such as boarding an airplane, but he was able to board the plane without it. He changed his breakfast to brown rice and stopped eating pasta.

【6th transplantation questionnaire】
I have improved a lot since the 5th transplant. Recently, I have banana stools. I have diarrhea when I drink alcohol. I eat brown rice in the morning. I stopped eating pasta. I am mentally stable. I don’t need Depas before riding a train anymore.

After the 6th transplant: I have maintained my condition after the 6th transplant. It worked dramatically. I don’t need Depas anymore. I have cut out wheat and dairy. I take vegetable juice and Supplement Lactis in the morning.

【7th transplantation questionnaire】
I have been having banana stools. I am doing well, but I only have bowel movements almost as often as I eat. I want to eat once a day. I am cutting back on wheat.

【8th transplantation questionnaire】
She has been doing well since her last transplant. Normal stools this morning.

【9th transplantation questionnaire】
No diarrhea, banana-like stools with one bowel movement in the morning. She rarely consumes eggs and wheat, but eats natto and kimchi every day, and also consumes a lot of meat and rice.

Changes after completion of transplant:.

Symptoms showed almost complete improvement.

Evaluation and Discussion

Transplant Evaluation:.	Moderate improvement of symptoms
Pre- and post-transplant flora balance test changes:.	［pre-transplant］The lack of diversity in the flora is a result of eating what you want, doing what you want, and living a self-centered life, which has led to this balance. Although partial improvement can be expected from transplantation, mental reinforcement may be a priority for lasting relief. [Post-transplant] August 2018. The overall balance is markedly improved by diversification of Clostridium genus, improvement of the balance of Clostridium genus that controls the mental aspect, and increase of Lactobacillus group. If I may say so, if the ratio of bifidobacteria increases a little more, the genus Bacteroides will be able to perform its original functions such as production of organic acids, and I expect that both mental and physical symptoms will be further improved.
Blood test changes:.	［After transplantation] None
POMS2 SCORE CHANGE:.	［After transplantation] None

＜Intestinal flora balance before and after transplantation＞

His/her experience (from the questionnaire):.

Retrieved August 2018
Before the transplant, I was anxious about the pain and other symptoms such as catheter insertion. I became accustomed to that anxiety or discomfort at the time of transplantation as I went through the process, and my symptoms were mostly improved at the end of the transplantation.

Adverse events: No

Nothing

Transplant General Comments and Discussion:.

Her diarrhea symptoms almost disappeared after 6 transplants, and her mental symptoms, such as anxiety when riding in a vehicle, which had always been present, also disappeared. After 3 more transplants, the patient had normal stools once a day and showed excellent improvement.

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