Fecal microbiota transplantation for severe enterocolonic fistulizing Crohn’s disease

Abstract

The concept of fecal microbiota transplantation (FMT) has been used in traditional Chinese medicine at least since the 4^th century. Evidence from recent human studies strongly supports the link between intestinal bacteria and inflammatory bowel disease. We proposed that standardized FMT might be a promising rescue therapy for refractory inflammatory bowel disease. However, there were no reports of FMT used in patients with severe Crohn’s disease (CD). Here, we report the successful treatment of standardized FMT as a rescue therapy for a case of refractory CD complicated with fistula, residual Barium sulfate and formation of intraperitoneal large inflammatory mass. As far as we know, this is the first case of severe CD treated using FMT through mid-gut.

Keywords: Fecal microbiota transplantation, Crohn’s disease, Rescue therapy, Inflammatory bowel disease, Fistula

Core tip: We proposed that standardized fecal microbiota transplantation (FMT) might be a promising rescue therapy for refractory inflammatory bowel disease. This case report provided the first description of severe Crohn’s disease in sustained clinical remission after FMT, and the brief protocol of patient preparation before and during FMT. Although there was only one case, the present result in our pilot clinical trial strongly supported our initial hypothesis and highlighted the attractive role of the remodeling of gut flora in host diseases.