Successful autologous fecal transplantation for chronic diversion colitis

Gundling, Felix; Tiller, Maximilian; Agha, Ayman; Schepp, Wolfgang; Iesalnieks, Igors

doi:10.1007/s10151-014-1220-2

Cited by 22 publications

(25 citation statements)

References 6 publications

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“…Promising results have also been reported for autologous faecal transplantation [10]. Most authors emphasize that although DC can be treated conservatively, the best and most successful method of DC treatment is surgery to reconstruct digestive tract continuity [9, 11].…”

Section: Discussionmentioning

confidence: 99%

Diversion colitis 25 years later: the phenomenon of the disease

Szczepkowski¹,

Banasiewicz

Kobus³

2017

Int J Colorectal Dis

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BackgroundDiversion colitis (DC) seems to be common in stoma patients, and the restoration of the continuity of the digestive tract is crucial for relief from the inflammatory process. No prospective studies of the late effects of DC on the lower gastrointestinal (GI) tract mucosa and the clinical condition of patients have been reported.MethodsData from 23 patients who underwent stoma creation were analysed during the reversal period (A) and at an average of 3 months (B1) and 5.6 years (B2) after restoration of GI tract continuity. Every monitoring visit included endoscopy, histology and assessment of the clinical condition of patients.ResultsShortly after GI tract restoration (B1), a significant decrease in inflammation was observed. The Ki67 positivity percentage increased, but this was not significant. At an average of 5.6 years after restoration (group B2), the clinical symptoms were mild. More patients presented with endoscopically detected inflammation of the mucosa, but its severity was not significantly higher than that at 3 months after reversal. Histological inflammation was more common, and its severity was significantly higher than that shortly after reversal but similar to that before reversal. The Ki67 positivity percentage decreased at the last examination (B2).ConclusionsThe results of this study show a complex recurrence of histological inflammation several years after GI tract restoration but without clinical and endoscopic inflammation and with good clinical condition. DC can potentially have a late influence on the rectal mucosa, even after stoma closure.

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Section: Discussionmentioning

confidence: 99%

Diversion colitis 25 years later: the phenomenon of the disease

Szczepkowski¹,

Banasiewicz

Kobus³

2017

Int J Colorectal Dis

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“…The efficacy of these approaches has not been confirmed, and surgical reanastomosis is the most reliable approach 2 3. Gundling et al have also reported successful autologous faecal transplantation in a patient with chronic diversion colitis 4. Autologous FMT is safe and inexpensive, with little risk of complications.…”

Section: Answer: Autologous Faecal Microbiota Transplantationmentioning

confidence: 99%

How do you treat this diversion ileitis and pouchitis?

Tominaga

Tsuchiya

Yokoyama

et al. 2018

Gut

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“…Fecal microbiota transplantation (FMT), which consists of transferring stool from a healthy donor to the patient’s colon, is an effective treatment for some diseases of the colon such as Crohn’s disease and recurrent Clostridium difﬁcile infections[ 67 ]. Gundling et al[ 45 ] presented that autologous FMT might be an effective and safe option for relapsing DC after standard therapies have failed. Since the interruption of the fecal stream is central to the development of DC, FMT seems to be a hopeful treatment.…”

Section: Clinical Charactersmentioning

confidence: 99%

“…In our review, SCFA[ 5 , 10 , 18 , 19 , 26 , 27 , 36 , 62 ], 5-ASA enemas[ 31 , 43 , 47 , 51 ], steroid enemas[ 21 , 32 , 33 ], and irrigation with fibers[ 65 , 66 ] have been tried with various efficacies for mucosal inflammation. Only case reports of therapy involving leukocytapheresis[ 44 ], autologous fecal microbiota transplantation (FMT)[ 45 ] and dextrose (hypertonic glucose) spray[ 29 ] have been tried with some effect. We have summarized the method, advantages and disadvantages of each pharmacologic treatment in Table 3 .…”

Section: Summary Of Pharmacologic Treatmentsmentioning

confidence: 99%

Diversion colitis and pouchitis: A mini-review

Tominaga

Kamimura

Takahashi

et al. 2018

WJG

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Diversion colitis is characterized by inﬂammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inﬂammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.

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Successful autologous fecal transplantation for chronic diversion colitis

Cited by 22 publications

References 6 publications

Diversion colitis 25 years later: the phenomenon of the disease

Diversion colitis 25 years later: the phenomenon of the disease

How do you treat this diversion ileitis and pouchitis?

Diversion colitis and pouchitis: A mini-review

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