Intestinal flora transplantation and case studies

Fecal microbiota transplantation in a 50-year-old woman with ulcerative colitis

Introduction of cases 50th generation women Ulcerative colitis

summary

FMT for ulcerative colitis (UC).
After starting FMT, he developed appendicitis, which was relieved by antibiotics. Thereafter, he had a temporary exacerbation (hemorrhage), but gradually improved, which was considered effective for UC.

Basic Information

Patients : Woman in her 50s
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 : Ulcerative colitis, reactive arthritis
At onset : Since about 1985
Transplant Purpose: To Improvement of disease, joint pain, etc.
Chief complaint : Arthralgia, stiffness, myalgia, fever, malaise, lower blood
Medical history : Unexplained severe abdominal pain and fatigue
fibromyalgia
Difficulty walking, venous malformation
Background, family history, lifestyle, supplement use, etc : Steroid medication, insomnia medications, etc.

Transplant Information

Transplantation period: from 2022/1/15~2022/2/26
Number of transplants : 6 transplants

Change from first transplant to end of transplant :

【1st transplantation questionnaire】
(From a patient)
Diarrhea 10 times a day for 3 days. Started taking Chinese herbal medicine yesterday and a little improvement. She continues to have abdominal pain and abdominal tightness. She has gas in her abdomen. Feels cold.

Evaluation after the first transplantation]FMT performed for active UC. Temporary appendicitis accompanied, but improved with antibiotics. There was a temporary exacerbation, but it improved. Lower blood loss improved and bowel movements stabilized.

【2nd transplantation questionnaire】
Right lower abdominal pain, improved by reverse abdominal breathing. They are experiencing the effect on transplantation. Anal herpes (vaccinated) with tenderness and small blisters. →Ointment and oral prescription for observation.
(From a patient)
Lighter in both mind and body. Less abdominal tightness and gas since transplant. I was sleepy for a few days after the transplant. I was able to sleep comfortably.

Right lower abdomen, pain during defecation.

【3rd transplantation questionnaire】
There is a smile. They seem surprised at the change. They seem to be experiencing the effects of the transplant.
(From a patient)
My mind and body felt lighter. I could drive to the clinic alone.

【4th transplantation questionnaire】
Abdominal turgor is mild and no gas. Prescribed Pulsenide for an intermittent use due to constipation tendency after transplantation.
(From a patient)
The day after the last transplant, there was pain in the appendix. He was prescribed antibiotics and transported by ambulance. Hospitalized for 3 days for chronic appendicitis.
CT abdomen with swelling. Symptoms calmed down and the patient was given a 4-day course of antibiotics. Tendency to constipation and headaches since transplant. Magnesium oxide taken internally, but defecation once every 4 days Bristol Scale Type 5-6 Little or no blood loss, but a little pink. Sleep better than before.

【5th transplantation questionnaire】
There is an indication that they are feeling the effects of the transplantation. Bowel movements need to be adjusted and will be adjusted by the family doctor.

(From a patient)
Stools do not come out clearly. Partial bleeding. A little abdominal tightness, but no pain in the appendicular area. When abdominal symptoms settled down, body aches started to appear. Family members say he is really feeling better. He is able to walk from the parking lot.

【6th transplantation questionnaire】
(From a patient)
Continuous bleeding. He tended to be constipated and also took laxatives (Daiken-chu-tang and sennoside). (He was dizzy yesterday under the influence of these drugs. There is concern about control of bowel movements and continuation of lower blood loss. She is laughing. No longer concerned about small things.

 

Intestinal flora balance Comparative data

Evaluation and Discussion

Transplant Evaluation : Moderate improvement of symptoms
Adverse events: No Nothing

 

Transplant Evaluation :
FMT performed for active UC. Temporary appendicitis accompanied, but improved with antibiotics. There was a temporary exacerbation, but it improved. At the 6-month follow-up, her flora was also improved, her symptoms tended to improve, and her quality of life improved. Mentally stable. Because her bowel movements were stable, rectal injection was discontinued. She continues to take immunosuppressive drugs and steroids, but the dosage can be reduced compared to that before FMT.

 

… and upwards

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