Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2024; 30(19): 2603-2611
Published online May 21, 2024. doi: 10.3748/wjg.v30.i19.2603
Intestinal microecological transplantation for a patient with chronic radiation enteritis: A case report
Lin Wang, Yan Li, Yu-Jing Zhang, Li-Hua Peng
Lin Wang, Yan Li, Yu-Jing Zhang, Li-Hua Peng, Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
Lin Wang, Yu-Jing Zhang, Department of Gastroenterology and Hepatology, Chinese PLA Medical School, Beijing 100853, China
Author contributions: Wang L was responsible for conceptualization and design of the study, data compilation and analysis, writing of the paper; Li Y, Zhang YJ were responsible for data compilation and analysis; Peng LH was responsible for conceptualization and design of the study, guiding the writing of the paper and quality control; all authors have read and agreed to the published version of the manuscript.
Informed consent statement: participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Hua Peng, MD, PhD, Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing 100853, China. penglihua301@126.com
Received: January 23, 2024
Revised: April 18, 2024
Accepted: April 22, 2024
Published online: May 21, 2024
Abstract
BACKGROUND

The gut microbiota is strongly associated with radiation-induced gut damage. This study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation enteritis.

CASE SUMMARY

A 64-year-old female with cervical cancer developed abdominal pain, diarrhea, and blood in the stool 1 year after radiotherapy. An electronic colonoscopy was performed to diagnose chronic radiation enteritis. Two courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were performed. The patient experienced short- and long-term relief from symptoms without adverse effects. Whole 16S rRNA sequencing revealed significant differences in the intestinal flora’s composition between patient and healthy donors. Pathogenic bacteria, such as Escherichia fergusonii and Romboutsia timonensis, were more in the patient. Beneficial bacteria such as Faecalibacterium prausnitzii, Fusicatenibacter saccharivorans, Ruminococcus bromii, and Bifidobacterium longum were more in the healthy donors. Intestinal microbiota transplantation resulted in a significant change in the patient's intestinal flora composition. The composition converged with the donor's flora, with an increase in core beneficial intestinal bacteria, such as Eubacterium rectale, and a decrease in pathogenic bacteria. Changes in the intestinal flora corresponded with the patients' alleviating clinical symptoms.

CONCLUSION

Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal flora. This study provides a new approach for treating patients with chronic radiation enteritis.

Keywords: Chronic radiation enteritis, Gut microbial transplantation, Intestinal microecology, Cancer, Quality of life, Case report

Core Tip: This study explores the efficacy of fecal microbiota transplantation (FMT) in a patient with chronic radiation enteritis. A 64-year-old patient experienced significant symptom relief and long-term remission after FMT. Microbial analysis revealed beneficial shifts in gut flora composition. This highlights FMT as a promising intervention for managing radiation-induced gastrointestinal complications, offering short-term relief and sustained benefits. Targeting intestinal microbiota presents a novel approach to improving patient outcomes and quality of life in chronic radiation enteritis, showing a potential paradigm shift in treatment strategies.