Case Report
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 7, 2013; 19(41): 7213-7216
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7213
Fecal microbiota transplantation for severe enterocolonic fistulizing Crohn’s disease
Fa-Ming Zhang, Hong-Gang Wang, Min Wang, Bo-Ta Cui, Zhi-Ning Fan, Guo-Zhong Ji
Fa-Ming Zhang, Hong-Gang Wang, Min Wang, Bo-Ta Cui, Zhi-Ning Fan, Guo-Zhong Ji, Digestive Endoscopy and Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
Author contributions: Zhang FM designed and organized the study and wrote the paper; Wang HG performed the lab work; Wang M joined in the clinical work; Cui BT performed the lab work; Fan ZN and Ji GZ were the attending doctors of this group.
Supported by (in part) The Public Donated Grant “Intestine Initiative”
Correspondence to: Fa-Ming Zhang MD, PhD, Digestive Endoscopy and Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, 121 Jiang Jiayuan, Nanjing 210011, Jiangsu Province, China. fzhang@njmu.edu.cn
Telephone: +86-25-58509883 Fax: + 86-25-58509931
Received: August 16, 2013
Revised: September 12, 2013
Accepted: September 15, 2013
Published online: November 7, 2013
Processing time: 91 Days and 18.9 Hours
Abstract

The concept of fecal microbiota transplantation (FMT) has been used in traditional Chinese medicine at least since the 4th 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.