Irritable bowel syndrome (diarrhea type), male in his 40s - fecal microbiota transplant case report

Irritable bowel syndrome (diarrhea type), male in his 40s – fecal microbiota transplant case report

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

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

summary

In her teens, she was diagnosed with fatty liver; in her 20s, she had chronic diarrhea and gas in her intestines; in her 30s, a colonoscopy revealed colon polyps, which were resected; in her 30s, a colonoscopy revealed inflammation at the end of the ileum.
In April 2018, he underwent a colonoscopy at the Kawauchi Internal Medicine Clinic, which revealed inflammation at the distal end of the ileum; in May, a gastrointestinal endoscopy revealed atrophic gastritis and a positive result for H. pylori, and he underwent eradication treatment. After the transplantation, diarrhea and gas accumulation in the intestine improved.

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	mid-20s
Transplant Purpose: To	diarrhea
Chief complaint:.	Irritable Bowel Syndrome Treatment
Medications being taken:.	Nothing
Medical history	Colorectal polyps Atrophic gastritis (H. pylori positive)
Background, family history, lifestyle, supplement use, etc.:.	Heart disease (mother)

Transplant Information

Transplantation period: from	May 22, 2018 – October 30, 2018
Number of transplants	6 times

Change from first transplant to end of transplant:.

【1st transplantation questionnaire】
He was in Vietnam until age 42, but his diarrhea has been getting worse since he returned to Japan. No abdominal pain.
Started Mazuren, Glimac, and Biofermin on 5/1 and felt abdominal discomfort and gas decreased, but gas has been accumulating for the past 2 days. 5/8 started Pylori eradication with Bonosap, and diarrhea continued 3 days a week while taking Bonosap. The eradication was completed and the patient has been receiving water for medical assistance since 5/16.

【2nd transplantation questionnaire】
She had diarrhea until 3 days ago, but has been having normal stools for the past 3 days.

【3rd transplantation questionnaire】
Farting has decreased since the last transplant. Diarrhea has decreased. 1 or 2 episodes of diarrhea/week, but no pain. No severe diarrhea. Feeling much better. (Examination after the 3rd transplant)

【4th transplantation questionnaire】
He had been working abroad for 90 days and was under constant stress. Eating more slowly than before. Banana-like stools 4-5 times/day.

【5th transplantation questionnaire】
Stools 3~4 times/day, banana-like in nature. No gas accumulation, no abdominal pain.

【6th transplantation questionnaire】
Diarrhea 3-5 days ago. Today is fine, but had 4 bowel movements from morning to noon. Stools seemed different and thicker. It was about a month after the 3rd transplant that I felt better than the last time.

Changes after completion of transplant:.

The effect could be felt from about a week after transplantation.

Evaluation and Discussion

Transplant Evaluation:.	Moderate improvement of symptoms
Pre- and post-transplant flora balance test changes:.	[Before implantation] Performed in May 2018. The flora balance appears to be such that functional dyspepsia is suspected. Although the ratio of bifidobacteria is ideal, there is little diversity of the immune-regulating Clostridium genus. [During transplantation] June 2018. There is a noticeable proliferation of bacteria resistant to medications, probably due to some influence (e.g., medication). There is a good suspicion of the presence of Clostridium spp. etc., which have not yet appeared on the balance sheet and which have been diversified by transplantation. [After transplant] Implemented in December 2018. The diversity of Clostridium genus has improved and the balance is improving. A few more improvements and the start of an increase in lactobacilli and bifidobacteria groups will lead to further improvement of symptoms.
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 June 2018
After the transplant, I felt the effects of the transplant as there was less gas buildup in my intestines. However, as the period of time has passed since the end of the transplant, I feel that I am not feeling it as much. I try to manage my food intake and eat yogurt every day.

Adverse events: No

Nothing

Transplant General Comments and Discussion:.

Regarding long-term symptoms, this is a case in which the transplant changed the flora and led to symptom improvement, although the patient was always affected by stress, which is still the base of the disease these days.

… and upwards

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This case was presented at the 3rd Annual Meeting.

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The number of actual fecal microbiota transplants by case in our study group is as follows Case reports by disease You can view case reports by disease from the links below: [Ulcerative Colitis]https://fmt-japan.org/research-activities/fmt-cases-index?tag=uc [Irritable Bowel Syndrome]https://fmt-japan.org/research-activities/fmt-cases-index?tag=ibs [Atopic Allergies]https://fmt-japan.org/research-activities/fmt-cases-index?tag=allergy [Constipation]https://fmt-japan.org/research-activities/fmt-cases-index?tag=constipation [ASD (Autism Spectrum Disorder)]https://fmt-japan.org/research-activities/fmt-cases-index?tag=asd [Other Diseases]https://fmt-japan.org/research-activities/fmt-cases-index?tag=others

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