{"id":10433,"date":"2019-07-31T14:28:49","date_gmt":"2019-07-31T05:28:49","guid":{"rendered":"https:\/\/symdfmtcopro.wpenginepowered.com\/post\/10433"},"modified":"2023-11-29T19:01:57","modified_gmt":"2023-11-29T10:01:57","slug":"irritable-bowel-syndrome-diarrhea-type-male-in-his-40s-fecal-microbiota-transplant-case-report","status":"publish","type":"post","link":"https:\/\/fmt-japan.org\/en\/post\/10433","title":{"rendered":"Irritable bowel syndrome (diarrhea type), male in his 40s &#8211; fecal microbiota transplant case report"},"content":{"rendered":"<h2><span class=\"ez-toc-section\" id=\"i\"><\/span>Case presentation: Male in his 40s, irritable bowel syndrome (diarrhea type)<span class=\"ez-toc-section-end\"><\/span><\/h2>\r\n<h3><span class=\"ez-toc-section\" id=\"i-2\"><\/span>summary<span class=\"ez-toc-section-end\"><\/span><\/h3>\r\n<p>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.<br \/>\r\nIn 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.<\/p>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<h3><span class=\"ez-toc-section\" id=\"i-3\"><\/span>Basic Information<span class=\"ez-toc-section-end\"><\/span><\/h3>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Patients:.<\/td>\r\n<td>40s Male<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Attending physician:.<\/td>\r\n<td><a href=\"https:\/\/www.kawai-medical.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">Kawai Internal Medicine Clinic<i class=\"icon-new-tab\"><\/i><\/a><\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Medical institution in charge of transplantation:.<\/td>\r\n<td><a href=\"https:\/\/www.kawai-medical.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">Kawai Internal Medicine Clinic<i class=\"icon-new-tab\"><\/i><\/a><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<h3><span class=\"ez-toc-section\" id=\"i-4\"><\/span>Information at the time of initial medical examination<span class=\"ez-toc-section-end\"><\/span><\/h3>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Disease name:.<\/td>\r\n<td>Irritable bowel syndrome (diarrhea type)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>At onset<\/td>\r\n<td>mid-20s<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Transplant Purpose: To<\/td>\r\n<td>diarrhea<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Chief complaint:.<\/td>\r\n<td>Irritable Bowel Syndrome Treatment<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Medications being taken:.<\/td>\r\n<td>Nothing<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Medical history<\/td>\r\n<td>Colorectal polyps<br \/>\r\nAtrophic gastritis (H. pylori positive)<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Background, family history, lifestyle, supplement use, etc.:.<\/td>\r\n<td>Heart disease (mother)<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<h3><span class=\"ez-toc-section\" id=\"i-5\"><\/span>Transplant Information<span class=\"ez-toc-section-end\"><\/span><\/h3>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Transplantation period: from<\/td>\r\n<td>May 22, 2018 &#8211; October 30, 2018<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Number of transplants<\/td>\r\n<td>6 times<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Change from first transplant to end of transplant:.<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>\u30101st transplantation questionnaire\u3011<br \/>\r\nHe was in Vietnam until age 42, but his diarrhea has been getting worse since he returned to Japan. No abdominal pain.<br \/>\r\nStarted 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.<\/p>\r\n<hr>\r\n<p>\u30102nd transplantation questionnaire\u3011<br \/>\r\nShe had diarrhea until 3 days ago, but has been having normal stools for the past 3 days.<\/p>\r\n<hr>\r\n<p>\u30103rd transplantation questionnaire\u3011<br \/>\r\nFarting 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)<\/p>\r\n<hr>\r\n<p>\u30104th transplantation questionnaire\u3011<br \/>\r\nHe had been working abroad for 90 days and was under constant stress. Eating more slowly than before. Banana-like stools 4-5 times\/day.<\/p>\r\n<hr>\r\n<p>\u30105th transplantation questionnaire\u3011<br \/>\r\nStools 3~4 times\/day, banana-like in nature. No gas accumulation, no abdominal pain.<\/p>\r\n<hr>\r\n<p>\u30106th transplantation questionnaire\u3011<br \/>\r\nDiarrhea 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.<\/p>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Changes after completion of transplant:.<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>The effect could be felt from about a week after transplantation.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<h3><span class=\"ez-toc-section\" id=\"i-6\"><\/span>Evaluation and Discussion<span class=\"ez-toc-section-end\"><\/span><\/h3>\r\n<table style=\"width: 100%;height: 409px\">\r\n<tbody>\r\n<tr style=\"height: 25px\">\r\n<td style=\"height: 25px;width: 16.7763%\">Transplant Evaluation:.<\/td>\r\n<td style=\"height: 25px;width: 83.114%\">Moderate improvement of symptoms<\/td>\r\n<\/tr>\r\n<tr style=\"height: 311px\">\r\n<td style=\"height: 311px;width: 16.7763%\">Pre- and post-transplant flora balance test changes:.<\/td>\r\n<td style=\"height: 311px;width: 83.114%\">[Before implantation] Performed in May 2018.<br \/>\r\nThe 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.<\/p>\r\n<hr>\r\n[During transplantation] June 2018.<br \/>\r\nThere 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.<\/p>\r\n<hr>\r\n[After transplant] Implemented in December 2018.<br \/>\r\nThe 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.<\/p>\r\n<\/td>\r\n<\/tr>\r\n<tr style=\"height: 25px\">\r\n<td style=\"height: 25px;width: 16.7763%\">Blood test changes:.<\/td>\r\n<td style=\"height: 25px;width: 83.114%\">\uff3bAfter transplantation] None<\/td>\r\n<\/tr>\r\n<tr style=\"height: 48px\">\r\n<td style=\"height: 48px;width: 16.7763%\">POMS2 SCORE CHANGE:.<\/td>\r\n<td style=\"height: 48px;width: 83.114%\">\uff3bAfter transplantation] None<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<p>\uff1cIntestinal flora balance before and after transplantation\uff1e<br \/>\r\n<img decoding=\"async\" class=\"aligncenter size-full wp-image-3511\" src=\"https:\/\/fmt-japan.org\/wp-content\/uploads\/2019\/07\/644036002466e3be81502c30b662167c.jpg\" alt=\"\" width=\"561\" height=\"368\" srcset=\"https:\/\/fmt-japan.org\/wp-content\/uploads\/2019\/07\/644036002466e3be81502c30b662167c.jpg 561w, https:\/\/fmt-japan.org\/wp-content\/uploads\/2019\/07\/644036002466e3be81502c30b662167c-300x197.jpg 300w\" sizes=\"(max-width: 561px) 100vw, 561px\" \/><\/p>\r\n<div class=\"su-table su-table-responsive su-table-fixed\">\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>His\/her experience (from the questionnaire):.<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Retrieved June 2018<br \/>\r\nAfter 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.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p>&nbsp;<\/p>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Adverse events: No<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Nothing<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<p>&nbsp;<\/p>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>Transplant General Comments and Discussion:.<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>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.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n&#8230; and upwards<\/p>\r\n<hr>\r\n<p><a href=\"https:\/\/fmt-japan.org\/category\/fmt_cases\">Return to Top of Case Studies<i class=\"icon-new-tab\"><\/i><\/a><\/p>\r\n\r\n<p class=\"wp-block-paragraph\">This case was presented at the <a href=\"https:\/\/fmt-japan.org\/4205\">3rd Annual Meeting<\/a>.<\/p>\r\n","protected":false},"excerpt":{"rendered":"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 [&hellip;]","protected":false},"author":1,"featured_media":11017,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[109],"tags":[122,103],"class_list":["post-10433","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fmt_cases","tag-irritable-bowel-syndrome","tag-medical-corporation-yuuakai-kawai-internal-medicine-clinic"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Irritable bowel syndrome (diarrhea type), male in his 40s - fecal microbiota transplant case report - \u8178\u5185\u30d5\u30ed\u30fc\u30e9\u79fb\u690d\u81e8\u5e8a\u7814\u7a76\u4f1a<\/title>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Irritable bowel syndrome (diarrhea type), male in his 40s - fecal microbiota transplant case report - \u8178\u5185\u30d5\u30ed\u30fc\u30e9\u79fb\u690d\u81e8\u5e8a\u7814\u7a76\u4f1a\" \/>\n<meta property=\"og:description\" content=\"Case presentation: Male in his 40s, irritable bowel syndrome (diarrhea type) summary In her teens, she was diagnosed with fatty liver; 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