lunes, 18 de julio de 2016

Crohn´s Disease In a 4 Year Old Treated with Fecal Microbiota Transplants

Crohn´s Disease In a 4 Year Old Treated with Fecal Microbiota Transplants

Female born by cesarean showing a severe atopic dermatitis at three months and at 6 months starts with bloody diarrhea. She is diagnosed as Crohn's disease as her ileum is severely compromised.Her initial treatment was enteral nutrition, supplements and folic acid until she is almost four years old, she never formed stools and her dermatitis persisted. She did not gain weight and had very low energy. She attended kindergarten but had to take frequent naps as she got exhausted very easily.When she was three and a half years her pediatric gastroenterologist recommended the parents to start with a very strong drug (a biologic) and that is when they decided to try something new they found searching the internet. They found some promising results by transforming the gut bacteria being replaced with healthy bacteria via enema. This is a different treatment choice for Crohn´s disease, disease that medicine still ignores where it comes from and why it stays with the patient for the rest of his days. The parents made a consultation with us and we frankly said we have treated other patients with Crohn´s disease but never did it on someone as young as Paula   (not the real name). We discussed the pros and cons and they decided to try doing Fecal Microbiota Transplants (FMTs) as the risks were minimum and the worst scenario could be that Paula did not get any benefit from the implants.Just to know where Paula´s inflammation status was we performed a fecal test called Fecal Calprotectin that can help us measure the progress or not of her treatment. Her initial value on July 7, 2015 was 779 units (normal value less than 50).Our first treatment was on August 27, 2015. The technique is quite simple and very well tolerated, it is performed through a very thin rectal catheter that reaches very high in her descending colon where we implant bacteria from a health donor that has been thoroughly studied and supervised every 60 days.We did daily implants for more than a month and around that time her mother noticed a marked improvement in her energy levels, her skin cleared, the dermatitis almost disappeared and her stools were gaining consistency. Five months later she is getting one FMT per week and her Fecal calprotectin is consistently low In the value of 130 units). She gained weight and has a normal child life, her hair got much better and never suffered again from her dermatitis.

   This is how Paula´s belly looks today, a normal flat belly
One very interesting feature we noticed was that she showed a very distended and tense belly before the treatment, nowadays her belly is totally flat and we can examine her gut with no difficult. Her appetite has increased and enjoys any meal as opposed before when she felt no enthusiasm about any food-

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