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Case Reports
, 10 (6), 975-980

Coordinated Hospital-Home Fecal Microbiota Transplantation via Percutaneous Endoscopic Cecostomy for Recurrent Steroid-Dependent Ulcerative Colitis

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Case Reports

Coordinated Hospital-Home Fecal Microbiota Transplantation via Percutaneous Endoscopic Cecostomy for Recurrent Steroid-Dependent Ulcerative Colitis

Xiaodong Ni et al. Gut Liver.

Abstract

Since its introduction as an alternative intestinal microbiota alteration approach, fecal microbiota transplantation (FMT) has been increasingly used as a treatment of choice for patients with ulcerative colitis (UC), but no reports exist regarding FMT via percutaneous endoscopic cecostomy (PEC). This report describes the case of a 24-year-old man with a 7-year history of recurrent, steroid-dependent UC. He received FMT via PEC once per day for 1 month in the hospital. After the remission of gastrointestinal symptoms, he was discharged from the hospital and continued FMT via PEC twice per week for 3 months at home. The frequency of stools decreased, and the characteristics of stools improved soon thereafter. Enteral nutrition was regained after 1 week, and an oral diet was begun 1 month later. Two months after the FMT end point, the patient resumed a normal diet, with formed soft stools once per day. The follow-up colonoscopy showed normal mucus membranes; then, the PEC set was removed. On the subsequent 12 months follow-up, the patient resumed orthobiosis without any gastrointestinal discomfort and returned to work. This case emphasizes that FMT via PEC can not only induce remission but also shorten the duration of hospitalization and reduce the medical costs; therefore, this approach should be considered an alternative option for patients with UC.

Keywords: Colitis, ulcerative; Fecal microbiota transplantation; Percutaneous endoscopic cecostomy.

Figures

Fig. 1
Fig. 1
Colonoscopic examination showed diffuse mucus hyperemia, erosion and ulcer formation in the total colon and rectum. (A) Transverse colon; (B, C) sigmoid colon; (D) rectum.
Fig. 2
Fig. 2
Endoscopic view of the cecum during percutaneous endoscopic cecostomy. (A) A 19-gauge Seldinger cannula was inserted into the cecum; (B) the gasket of the cecostomy tube.
Fig. 3
Fig. 3
Colonoscopic examination showed scattered small ulcers in the rectum with smooth mucus membranes in the colon. (A) Sigmoid colon; (B) rectum.
Fig. 4
Fig. 4
Colonoscopy examination showed no lesions in the colon and rectum. (A) Colon; (B) rectum.

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