This study evaluated the efficacy and safety of fecal microbiota transplantation (FMT) for 12 patients with diarrhea-predominant irritable bowel syndrome (IBS-D). Baseline symptoms and scores were assessed using IBS severity scores, Birmingham IBS symptom scores, and quality of life questionnaires. Patients underwent FMT and were followed up at 1, 3, and 6 months. Scores showed significant improvement from baseline to 3 months after FMT, including reduced IBS severity scores and Birmingham scores. FMT was found to provide significant symptom relief for IBS-D over 6 months with no serious adverse events reported.
Usefulness of Bifidobacterium longum BB536.pdfNgnH133
This randomized controlled trial investigated the effects of the probiotic Bifidobacterium longum BB536 in treating chronic constipation in elderly individuals. 80 elderly adults with chronic constipation were randomly assigned to receive either B. longum BB536 or a placebo daily for 4 weeks. While the primary endpoint of differences in constipation scoring between groups was not significant, within the BB536 group constipation scores significantly improved from baseline to week 4. Additionally, stool frequency significantly increased and difficulty with evacuation tended to decrease more in the BB536 group compared to placebo. The probiotic was found to be safe with few reported adverse effects.
Probiotics may play a role in inflammatory bowel disease (IBD). In ulcerative colitis, probiotics like VSL#3 have been shown to induce remission in mild-to-moderate disease, maintain remission, and treat pouchitis. Certain probiotic strains are more effective than others. In Crohn's disease, VSL#3 and S. boulardii have demonstrated benefits like maintaining remission and improving intestinal permeability when used as an adjunct to standard therapies. Well-designed studies provide evidence for the therapeutic potential of specific probiotic strains in both ulcerative colitis and Crohn's disease.
This document summarizes a study of 233 cases of abdominal tuberculosis treated at a hospital in Pakistan from 2003-2008. Some key findings include:
- The average age was 28 years and most patients were from poor families.
- The most common presentation was acute abdomen (67%), requiring emergency surgery. Common surgical findings included intestinal strictures (69%).
- Most cases involved the ileocecal region and presented as intestinal obstructions.
- The majority of cases were considered primary abdominal tuberculosis, though some had a history of pulmonary TB.
- Most patients required hospitalization, with an average stay of 19.5 days. The in-hospital mortality rate was 2.1%.
This study evaluated the effects of probiotic therapy in patients with mild to moderate ulcerative colitis. 70 male patients were randomly assigned to receive either mesalamine or probiotic treatment for 3 months. Both treatments showed statistically significant improvements in disease parameters and inflammation markers. Clinical remission occurred within 1-2 months for most patients in both groups. Probiotic therapy was also effective at maintaining remission in 85.7% of patients for over 6 months. The study concluded that probiotics can effectively treat and maintain remission of mildly to moderately severe ulcerative colitis.
Bone marrow transplant (BMT) recipients often require parenteral nutrition (PN) to meet their nutrient needs. While general guidelines for the provision of PN support by nutrition support teams (NSTs) have been shown to decrease inappropriate PN use, recommendations for nutrition in BMT recipients are lacking. We reviewed the charts of patients status post BMT on PN to determine whether institutional guidelines for PN initiation and continuous supervision of NSTs could be applied in this population. With the Institutional Review Board (IRB) approval, charts of adult BMT recipients on PN between June 14, 2006 and June 30, 2007 were examined. Sixty-nine charts were reviewed. Indications for initiation of PN included severe mucositis, graft versus host disease (GVHD), and other transplant related side effects resulting in poor oral intake. Among 69 patients, 37 (54%) had severe mucositis, 12 (17%) had GVHD, 2 (3%) had both mucositis and GVHD, and 18 (26%) had other side effects. It was determined that all patients met the criteria for initiation of PN support, as outlined in the guidelines form. Comprehensive guidelines for initiating PN support, developed by NSTs can also be used for BMT recipients in order to optimize their nutritional status.
Intermittent bolus feeding versus continuous enteral feedingDr. Prashant Kumar
Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favour of intermittent enteral nutrition administration, where volume is infused multiple times per day.
This presentation will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults.
- Irritable bowel syndrome (IBS) affects 7-21% of the general population and is the most commonly diagnosed gastrointestinal condition. It is defined by abdominal pain or discomfort with altered bowel habits in the absence of underlying disease.
- Factors that contribute to IBS include alterations in the gut microbiome, intestinal permeability, immune function, motility, sensation, brain-gut interactions, and psychosocial status. Dietary triggers and a history of infection or antibiotics can also play a role.
- IBS substantially reduces quality of life and productivity. While some patients improve over time, it is generally a chronic relapsing condition. Diagnosis involves symptom evaluation and exclusion of other diseases through selected testing. Management
Usefulness of Bifidobacterium longum BB536.pdfNgnH133
This randomized controlled trial investigated the effects of the probiotic Bifidobacterium longum BB536 in treating chronic constipation in elderly individuals. 80 elderly adults with chronic constipation were randomly assigned to receive either B. longum BB536 or a placebo daily for 4 weeks. While the primary endpoint of differences in constipation scoring between groups was not significant, within the BB536 group constipation scores significantly improved from baseline to week 4. Additionally, stool frequency significantly increased and difficulty with evacuation tended to decrease more in the BB536 group compared to placebo. The probiotic was found to be safe with few reported adverse effects.
Probiotics may play a role in inflammatory bowel disease (IBD). In ulcerative colitis, probiotics like VSL#3 have been shown to induce remission in mild-to-moderate disease, maintain remission, and treat pouchitis. Certain probiotic strains are more effective than others. In Crohn's disease, VSL#3 and S. boulardii have demonstrated benefits like maintaining remission and improving intestinal permeability when used as an adjunct to standard therapies. Well-designed studies provide evidence for the therapeutic potential of specific probiotic strains in both ulcerative colitis and Crohn's disease.
This document summarizes a study of 233 cases of abdominal tuberculosis treated at a hospital in Pakistan from 2003-2008. Some key findings include:
- The average age was 28 years and most patients were from poor families.
- The most common presentation was acute abdomen (67%), requiring emergency surgery. Common surgical findings included intestinal strictures (69%).
- Most cases involved the ileocecal region and presented as intestinal obstructions.
- The majority of cases were considered primary abdominal tuberculosis, though some had a history of pulmonary TB.
- Most patients required hospitalization, with an average stay of 19.5 days. The in-hospital mortality rate was 2.1%.
This study evaluated the effects of probiotic therapy in patients with mild to moderate ulcerative colitis. 70 male patients were randomly assigned to receive either mesalamine or probiotic treatment for 3 months. Both treatments showed statistically significant improvements in disease parameters and inflammation markers. Clinical remission occurred within 1-2 months for most patients in both groups. Probiotic therapy was also effective at maintaining remission in 85.7% of patients for over 6 months. The study concluded that probiotics can effectively treat and maintain remission of mildly to moderately severe ulcerative colitis.
Bone marrow transplant (BMT) recipients often require parenteral nutrition (PN) to meet their nutrient needs. While general guidelines for the provision of PN support by nutrition support teams (NSTs) have been shown to decrease inappropriate PN use, recommendations for nutrition in BMT recipients are lacking. We reviewed the charts of patients status post BMT on PN to determine whether institutional guidelines for PN initiation and continuous supervision of NSTs could be applied in this population. With the Institutional Review Board (IRB) approval, charts of adult BMT recipients on PN between June 14, 2006 and June 30, 2007 were examined. Sixty-nine charts were reviewed. Indications for initiation of PN included severe mucositis, graft versus host disease (GVHD), and other transplant related side effects resulting in poor oral intake. Among 69 patients, 37 (54%) had severe mucositis, 12 (17%) had GVHD, 2 (3%) had both mucositis and GVHD, and 18 (26%) had other side effects. It was determined that all patients met the criteria for initiation of PN support, as outlined in the guidelines form. Comprehensive guidelines for initiating PN support, developed by NSTs can also be used for BMT recipients in order to optimize their nutritional status.
Intermittent bolus feeding versus continuous enteral feedingDr. Prashant Kumar
Early enteral nutrition is recommended in critically ill adult patients. The optimal method of administering enteral nutrition remains unknown. Continuous enteral nutrition administration in critically ill patients remains the most common practice worldwide; however, its practice has recently been called into question in favour of intermittent enteral nutrition administration, where volume is infused multiple times per day.
This presentation will outline the key differences between continuous and intermittent enteral nutrition, describe the metabolic responses to continuous and intermittent enteral nutrition administration and outline recent studies comparing continuous with intermittent enteral nutrition administration on outcomes in critically ill adults.
- Irritable bowel syndrome (IBS) affects 7-21% of the general population and is the most commonly diagnosed gastrointestinal condition. It is defined by abdominal pain or discomfort with altered bowel habits in the absence of underlying disease.
- Factors that contribute to IBS include alterations in the gut microbiome, intestinal permeability, immune function, motility, sensation, brain-gut interactions, and psychosocial status. Dietary triggers and a history of infection or antibiotics can also play a role.
- IBS substantially reduces quality of life and productivity. While some patients improve over time, it is generally a chronic relapsing condition. Diagnosis involves symptom evaluation and exclusion of other diseases through selected testing. Management
FECAL Microbiota TRANSPLANTATION by Mohammmed Samir.pptxsally2ayman
Fecal microbiota transplantation (FMT) involves transferring stool from a healthy donor to a recipient patient to restore gut microbiome balance. It has shown success treating recurrent Clostridium difficile infection and is being studied for other conditions like inflammatory bowel disease. Key aspects of FMT include rigorous donor screening, informed consent, administration methods like colonoscopy, and monitoring recipients. Potential indications are recurrent C. difficile, IBD, antibiotic-associated diarrhea, while contraindications involve risks of infection, bleeding, or inability to comply with the procedure. FMT holds promise but requires more research regarding safety, efficacy, and protocols for different conditions.
This article presents a case report of a 26-year-old woman diagnosed with hereditary angioedema (HAE) with intestinal involvement after 13 years of recurrent abdominal pain, diarrhea, nausea, and swelling of the hands, lips and eyelids. Over this period, she underwent six laparoscopic surgeries that revealed small amounts of free intraperitoneal fluid but no definitive cause of her symptoms. Biochemical testing found decreased levels of C1 esterase inhibitor and C4, confirming the diagnosis of HAE. Treatment with oxandrolone has partially controlled her abdominal pain attacks by decreasing their frequency. The case report discusses the challenges of diagnosing intestinal angioedema and highlights the importance of considering HAE
Journal club Probiotics .pptx in Post op Patients of Gastroduodenal perforati...DrAshishBhardwaj1
This study aimed to evaluate if probiotics aid in the recovery of gastrointestinal motility after surgery for gastro-duodenal perforation peritonitis. 88 patients who underwent emergency surgery for this condition were randomized to receive probiotics or not after surgery. Results found no significant differences between the groups in time to first bowel sounds or flatus, white blood cell counts, complications, length of stay, or mortality. While probiotics have shown benefits after elective abdominal surgeries, this study found no advantages of probiotics for recovery after emergency surgery for perforated gastro-duodenal perforation peritonitis.
Effect of Antibiotics on The Gut Microbiota in Children with Chronic Pancreat...JohnJulie1
Little is known about the effect of antibiotic treatment on the gut microbiota in children with chronic pancreatitis (CCP). Our objective was to identify the effect of antibiotic treatment on the gut microbiota in children with chronic pancreatitis (CCP), the main gut microbiota genera and characterize the patients’ functional mutations after using antibiotics.
Constipation is the symptom and is associated with primary & Secondary causes. Constipation is defined as occurrence of >3 episodes of bowel movements. the Rome III criteria defines the objective classification and bristol stool chart helps in assessing the type of stools passed. Management of constipation deals with early assess, treating the cause, adjuvant management, Pharmacological Management (laxatives, suppositories & enemas) and following constipation prevention bundle.
How to achieve deep remission in treatment of inflammatory bowel disease.Younis I Munshi
The document discusses methods for achieving deep remission in treatment of inflammatory bowel disease (IBD). Deep remission means achieving both symptomatic and mucosal remission. Optimization of conventional therapy, early treatment, use of the Lemann score to assess damage, performance of double-balloon endoscopy, treatment using Traditional Chinese Medicine, and good communication between physicians and patients are needed to attain deep remission. Using these methods can help change the course of the disease, improve patient prognoses, and increase quality of life by minimizing complications and bowel damage.
This document discusses small intestinal bacterial overgrowth (SIBO). It provides background on SIBO, including definitions, prevalence, clinical presentation, and diagnostic testing methods. The main diagnostic tests discussed are breath testing, antibiotic treatment trials, and small bowel aspiration/culture. Treatment options outlined include antibiotic therapy, prokinetic agents, probiotics, and nutritional support. Management of SIBO aims to address underlying causes, eradicate bacterial overgrowth, and provide nutritional support.
The document summarizes key information about functional gastrointestinal disorders (FGIDs):
- FGIDs affect 40% of patients seen in GI settings and are a leading cause of emergency referrals. They are defined by symptoms in the absence of structural abnormalities and involve motility, sensitivity, immune, and central nervous system abnormalities.
- Food can trigger FGID symptoms in many patients. Dietary triggers may involve immune activation, direct effects of food chemicals, or carbohydrate malabsorption. Low FODMAP and gluten-free diets can provide relief.
- A multidisciplinary approach including a gastroenterologist, psychologist, dietician, and others results in significantly reduced anxiety and depression in FGID patients
Faecal transplantation for the treatment of c. defficle associated disease Anjum Hashmi MPH
This document discusses fecal microbiota transplantation (FMT) as a treatment for recurrent Clostridium difficile infection. It describes the screening process for stool donors, preparation of stool samples, and transplantation procedure. It then summarizes the results of FMT in 18 patients, finding that diarrhea resolved in most patients with one case of recurrence. It concludes that FMT is an effective and safe treatment for recurrent C. difficile infection.
Abdominal Tuberculosis Revisited–A single institutional experience of 72 case...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
gutCARE IBS Talk on 20/5/2020.
In this talk, we update Singapore local epidemiology about increasing trend of IBS locally since 1998. There is also challenges in diagnosing IBS confidently in primary care due to patient presentation and symptoms.
We also update audience about latest diagnostic criteria for IBS.
New treatment for IBS, relationship between Small intestine bacterial overgrowth and IBS and the role of hydrogen breath testing in managing IBS.
We hope you enjoy the slides.
This document provides guidelines for the diagnosis, treatment and prevention of Clostridium difficile infections (CDI). It summarizes key recommendations with evidence grading. For diagnosis, it recommends nucleic acid amplification tests over toxin enzyme immunoassays, and only testing diarrheal stool samples. It stratifies treatment based on disease severity into mild-moderate (treat with metronidazole), severe (vancomycin with/without metronidazole), and complicated (vancomycin orally and rectally with intravenous metronidazole). It also covers recurrent CDI treatment, managing CDI in patients with comorbidities, and infection control practices like contact precautions and environmental disinfection. The guidelines
The document discusses the therapeutic potential of fecal microbiota transplantation (FMT). It describes how the gut microbiome can be altered by factors like diet, prebiotics, probiotics, and antibiotics. FMT has been shown to effectively treat recurrent or severe Clostridium difficile infection by restoring a healthy microbiome. The document reviews the methods of administering FMT and discusses its potential applications for other conditions like inflammatory bowel disease, metabolic disorders, and more. Controlled studies are still needed to fully evaluate FMT's therapeutic effects.
Corrosive Induced Gastric Outlet Obstruction in Childrensemualkaira
Patients with gastric outlet obstruction, secondary to corrosive ingestion admitted in pediatric surgery department from January 2005 to June 2016. Most common corrosive
was sulphuric acid and it was taken accidentally by pediatric groups. Besides this, hydrochloric
acid, carbolic acid, sodium hydroxide, sodium hypochlorite, sodium carbonate etc are also common. Following conservative treatment, patients developed gastric outlet obstruction within 12 to
20 days. Surgery was performed to relief obstruction.
Circulating Tumor Cells and Cell-Free Nucleic Acids as Predictor Factors for ...AnonIshanvi
Pancreatic cancer remains as one of the most aggressive and deadliest of cancers largely due to formidable challenges in diagnosis and therapy. Consensus standard treatment for patients with nonmetastatic Pancreatic Cancer (PC) incorporates possible neoadjuvant chemotherapy with timely surgical resection and adjuvant chemotherapy. However, despite all the sophistication of modern radiological and endoscopic techniques, the decision regarding operability is often only made intra-operatively, therefore subjecting a patient to unnecessary surgical intervention, and postponing the possibility of starting early chemotherapy.
Research Progress in Chronic Lymphocytic LeukemiaAnonIshanvi
Cancer is an uncontrolled division of cell occurs due to genetic alterations and mutation. Chronic lymphocytic leukemia is the heterogeneous lymphocytic malignancy worldwide that leads to death.
Genetics of Breast and Ovary Cancers Associated with Hereditary Cancers and t...AnonIshanvi
Carriers of the BRCA-1/2 mutation have increased and variable risks of Breast Cancer (BC) and ovarian cancer and vary or are modified by common genetic variants and their incidence genetic testing and risk-reducing surgery has increased, they should receive advice and evaluation by the physician with experience in genetics.
Increased of Protein O-Fucosyl Transferase 1 and 2 Genes Expression in Gastri...AnonIshanvi
Gastric cancer is one of the most common cancers in the world. Gastric cancer usually occurs at an advanced age (average ≥ 65 years) and has symptoms similar to gastric ulcers and other gastric infections, its early diagnosis is one of the major problems of this type of cancer. Molecular mechanisms initiate cancer and the molecular changes of normal cells compared to cancer cells are very important. dysfunction of Fucosyl transferase enzymes is associated with gastric cancer.
The impact of the SARS-CoV-2 infection in all areas at the national and international level is undeniable, the aftermath of this “tornado” will be visible for a long time, even when the infection manages to be controlled. Two aspects of great interest to those of us who work in the area of oncology must be considered: on the one hand, the need to contain and control the devastating effects of the disease forced a reorganization in the operation of services, giving priority to COVID, conversion of medical units to hospitals COVID created a high-risk scenario for patients with other types of pathologies; This reorganization includes the allocation of large amounts of budget to COVID areas to the detriment of patients with other types of equally serious diseases - such as cancer, among others - who cannot wait for care in better times.
Meta-Analysis of Lateral Lymph Node Dissection for Mid Lower Rectal Cancer: I...AnonIshanvi
Presence of lateral lymph node metastasis in rectal cancer was originally reported in the 1950s.Lateral lymph node metastasis occurs in 15 to 20% of patients with locally advanced low rectal cancer which escalates likelihood of local recurrence and reduced survival following neoadjuvant chemoradiotherapy (nCRT) and Total Mesolectal Excision (TME).
More Related Content
Similar to Postpartum Meningitis by Enterococcus Faecalis Secondary to Neuraxial Anesthesia
FECAL Microbiota TRANSPLANTATION by Mohammmed Samir.pptxsally2ayman
Fecal microbiota transplantation (FMT) involves transferring stool from a healthy donor to a recipient patient to restore gut microbiome balance. It has shown success treating recurrent Clostridium difficile infection and is being studied for other conditions like inflammatory bowel disease. Key aspects of FMT include rigorous donor screening, informed consent, administration methods like colonoscopy, and monitoring recipients. Potential indications are recurrent C. difficile, IBD, antibiotic-associated diarrhea, while contraindications involve risks of infection, bleeding, or inability to comply with the procedure. FMT holds promise but requires more research regarding safety, efficacy, and protocols for different conditions.
This article presents a case report of a 26-year-old woman diagnosed with hereditary angioedema (HAE) with intestinal involvement after 13 years of recurrent abdominal pain, diarrhea, nausea, and swelling of the hands, lips and eyelids. Over this period, she underwent six laparoscopic surgeries that revealed small amounts of free intraperitoneal fluid but no definitive cause of her symptoms. Biochemical testing found decreased levels of C1 esterase inhibitor and C4, confirming the diagnosis of HAE. Treatment with oxandrolone has partially controlled her abdominal pain attacks by decreasing their frequency. The case report discusses the challenges of diagnosing intestinal angioedema and highlights the importance of considering HAE
Journal club Probiotics .pptx in Post op Patients of Gastroduodenal perforati...DrAshishBhardwaj1
This study aimed to evaluate if probiotics aid in the recovery of gastrointestinal motility after surgery for gastro-duodenal perforation peritonitis. 88 patients who underwent emergency surgery for this condition were randomized to receive probiotics or not after surgery. Results found no significant differences between the groups in time to first bowel sounds or flatus, white blood cell counts, complications, length of stay, or mortality. While probiotics have shown benefits after elective abdominal surgeries, this study found no advantages of probiotics for recovery after emergency surgery for perforated gastro-duodenal perforation peritonitis.
Effect of Antibiotics on The Gut Microbiota in Children with Chronic Pancreat...JohnJulie1
Little is known about the effect of antibiotic treatment on the gut microbiota in children with chronic pancreatitis (CCP). Our objective was to identify the effect of antibiotic treatment on the gut microbiota in children with chronic pancreatitis (CCP), the main gut microbiota genera and characterize the patients’ functional mutations after using antibiotics.
Constipation is the symptom and is associated with primary & Secondary causes. Constipation is defined as occurrence of >3 episodes of bowel movements. the Rome III criteria defines the objective classification and bristol stool chart helps in assessing the type of stools passed. Management of constipation deals with early assess, treating the cause, adjuvant management, Pharmacological Management (laxatives, suppositories & enemas) and following constipation prevention bundle.
How to achieve deep remission in treatment of inflammatory bowel disease.Younis I Munshi
The document discusses methods for achieving deep remission in treatment of inflammatory bowel disease (IBD). Deep remission means achieving both symptomatic and mucosal remission. Optimization of conventional therapy, early treatment, use of the Lemann score to assess damage, performance of double-balloon endoscopy, treatment using Traditional Chinese Medicine, and good communication between physicians and patients are needed to attain deep remission. Using these methods can help change the course of the disease, improve patient prognoses, and increase quality of life by minimizing complications and bowel damage.
This document discusses small intestinal bacterial overgrowth (SIBO). It provides background on SIBO, including definitions, prevalence, clinical presentation, and diagnostic testing methods. The main diagnostic tests discussed are breath testing, antibiotic treatment trials, and small bowel aspiration/culture. Treatment options outlined include antibiotic therapy, prokinetic agents, probiotics, and nutritional support. Management of SIBO aims to address underlying causes, eradicate bacterial overgrowth, and provide nutritional support.
The document summarizes key information about functional gastrointestinal disorders (FGIDs):
- FGIDs affect 40% of patients seen in GI settings and are a leading cause of emergency referrals. They are defined by symptoms in the absence of structural abnormalities and involve motility, sensitivity, immune, and central nervous system abnormalities.
- Food can trigger FGID symptoms in many patients. Dietary triggers may involve immune activation, direct effects of food chemicals, or carbohydrate malabsorption. Low FODMAP and gluten-free diets can provide relief.
- A multidisciplinary approach including a gastroenterologist, psychologist, dietician, and others results in significantly reduced anxiety and depression in FGID patients
Faecal transplantation for the treatment of c. defficle associated disease Anjum Hashmi MPH
This document discusses fecal microbiota transplantation (FMT) as a treatment for recurrent Clostridium difficile infection. It describes the screening process for stool donors, preparation of stool samples, and transplantation procedure. It then summarizes the results of FMT in 18 patients, finding that diarrhea resolved in most patients with one case of recurrence. It concludes that FMT is an effective and safe treatment for recurrent C. difficile infection.
Abdominal Tuberculosis Revisited–A single institutional experience of 72 case...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
gutCARE IBS Talk on 20/5/2020.
In this talk, we update Singapore local epidemiology about increasing trend of IBS locally since 1998. There is also challenges in diagnosing IBS confidently in primary care due to patient presentation and symptoms.
We also update audience about latest diagnostic criteria for IBS.
New treatment for IBS, relationship between Small intestine bacterial overgrowth and IBS and the role of hydrogen breath testing in managing IBS.
We hope you enjoy the slides.
This document provides guidelines for the diagnosis, treatment and prevention of Clostridium difficile infections (CDI). It summarizes key recommendations with evidence grading. For diagnosis, it recommends nucleic acid amplification tests over toxin enzyme immunoassays, and only testing diarrheal stool samples. It stratifies treatment based on disease severity into mild-moderate (treat with metronidazole), severe (vancomycin with/without metronidazole), and complicated (vancomycin orally and rectally with intravenous metronidazole). It also covers recurrent CDI treatment, managing CDI in patients with comorbidities, and infection control practices like contact precautions and environmental disinfection. The guidelines
The document discusses the therapeutic potential of fecal microbiota transplantation (FMT). It describes how the gut microbiome can be altered by factors like diet, prebiotics, probiotics, and antibiotics. FMT has been shown to effectively treat recurrent or severe Clostridium difficile infection by restoring a healthy microbiome. The document reviews the methods of administering FMT and discusses its potential applications for other conditions like inflammatory bowel disease, metabolic disorders, and more. Controlled studies are still needed to fully evaluate FMT's therapeutic effects.
Corrosive Induced Gastric Outlet Obstruction in Childrensemualkaira
Patients with gastric outlet obstruction, secondary to corrosive ingestion admitted in pediatric surgery department from January 2005 to June 2016. Most common corrosive
was sulphuric acid and it was taken accidentally by pediatric groups. Besides this, hydrochloric
acid, carbolic acid, sodium hydroxide, sodium hypochlorite, sodium carbonate etc are also common. Following conservative treatment, patients developed gastric outlet obstruction within 12 to
20 days. Surgery was performed to relief obstruction.
Similar to Postpartum Meningitis by Enterococcus Faecalis Secondary to Neuraxial Anesthesia (16)
Circulating Tumor Cells and Cell-Free Nucleic Acids as Predictor Factors for ...AnonIshanvi
Pancreatic cancer remains as one of the most aggressive and deadliest of cancers largely due to formidable challenges in diagnosis and therapy. Consensus standard treatment for patients with nonmetastatic Pancreatic Cancer (PC) incorporates possible neoadjuvant chemotherapy with timely surgical resection and adjuvant chemotherapy. However, despite all the sophistication of modern radiological and endoscopic techniques, the decision regarding operability is often only made intra-operatively, therefore subjecting a patient to unnecessary surgical intervention, and postponing the possibility of starting early chemotherapy.
Research Progress in Chronic Lymphocytic LeukemiaAnonIshanvi
Cancer is an uncontrolled division of cell occurs due to genetic alterations and mutation. Chronic lymphocytic leukemia is the heterogeneous lymphocytic malignancy worldwide that leads to death.
Genetics of Breast and Ovary Cancers Associated with Hereditary Cancers and t...AnonIshanvi
Carriers of the BRCA-1/2 mutation have increased and variable risks of Breast Cancer (BC) and ovarian cancer and vary or are modified by common genetic variants and their incidence genetic testing and risk-reducing surgery has increased, they should receive advice and evaluation by the physician with experience in genetics.
Increased of Protein O-Fucosyl Transferase 1 and 2 Genes Expression in Gastri...AnonIshanvi
Gastric cancer is one of the most common cancers in the world. Gastric cancer usually occurs at an advanced age (average ≥ 65 years) and has symptoms similar to gastric ulcers and other gastric infections, its early diagnosis is one of the major problems of this type of cancer. Molecular mechanisms initiate cancer and the molecular changes of normal cells compared to cancer cells are very important. dysfunction of Fucosyl transferase enzymes is associated with gastric cancer.
The impact of the SARS-CoV-2 infection in all areas at the national and international level is undeniable, the aftermath of this “tornado” will be visible for a long time, even when the infection manages to be controlled. Two aspects of great interest to those of us who work in the area of oncology must be considered: on the one hand, the need to contain and control the devastating effects of the disease forced a reorganization in the operation of services, giving priority to COVID, conversion of medical units to hospitals COVID created a high-risk scenario for patients with other types of pathologies; This reorganization includes the allocation of large amounts of budget to COVID areas to the detriment of patients with other types of equally serious diseases - such as cancer, among others - who cannot wait for care in better times.
Meta-Analysis of Lateral Lymph Node Dissection for Mid Lower Rectal Cancer: I...AnonIshanvi
Presence of lateral lymph node metastasis in rectal cancer was originally reported in the 1950s.Lateral lymph node metastasis occurs in 15 to 20% of patients with locally advanced low rectal cancer which escalates likelihood of local recurrence and reduced survival following neoadjuvant chemoradiotherapy (nCRT) and Total Mesolectal Excision (TME).
Analyzing Speech Outcomes in Hemiglossectomy Patients Using Telecare PlatformAnonIshanvi
This study analyzed speech outcomes in 20 patients who underwent hemiglossectomy for tongue cancer and reconstruction using a radial forearm free flap. The study aimed to evaluate the feasibility of using telemedicine for clinical research during COVID-19 and to analyze factors influencing postoperative speech outcomes. Patients completed speech evaluations remotely with speech language pathologists, assessing range of motion, speech clarity, articulation rate, and a speech handicap questionnaire. Early tumor stage, no radiation therapy, and base of tongue cancer were associated with better speech outcomes, particularly range of motion and clarity. Telemedicine was found to be an effective platform for conducting this clinical research during the pandemic.
Uterine Myoma, Risk Factor and Pathophysiology: A Review ArticleAnonIshanvi
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- The tumors are thought to be sensitive to estrogen and progesterone levels, which may explain why they typically grow during reproductive years and shrink after menopause.
- Cells in uterine myomas have a higher density of estrogen receptors compared to normal uterine muscle cells, and they convert estrogen to weaker forms less efficiently. This creates a relatively hyperestrogenic environment conducive to tumor growth.
Functional Disparity of Carcinoma Associated Fibroblasts in Different Stages ...AnonIshanvi
This document reports on a study that found functional differences between carcinoma-associated fibroblasts (CAFs) isolated from two different stages of breast cancer in a mouse model. CAFs isolated from stage 2 tumors (CAF-II) exhibited higher expression of immune-suppressive enzymes IDO and TGF-β compared to CAFs from stage 4 tumors (CAF-IV), which exhibited higher expression of iNOS and IL-10. This suggests the tumor microenvironments influenced by CAFs differ between cancer stages, which may contribute to varying responses to cancer therapies depending on the stage. Further research is needed to fully understand how CAF functions change during cancer progression and their potential as therapeutic targets at different stages.
Linitis plastica is a diffuse form of gastric cancer and accounts for about 10% of all cases of gastric malignancy and its exact general population distribution is unknown. There are no characteristic or specific symptoms, the symptoms are similar to those of other forms of stomach cancer and can manifest as a feeling of fullness after eating, nausea and vomiting, epigastric pain, weight loss, and progressive dysphagia [1]. Plastic linitisis characterized by malignant glandular proliferation of cricoid cells in the fibrous stroma, which ultimately leads to thickening and rigidity of the stomach wall.
This document discusses principles of cancer screening and summarizes a proposed cancer screening program called CitiScreen. It begins by outlining the Wilson-Jungner criteria for cancer screening approved by the WHO. It then discusses updated screening criteria and reviews the scientific basis for cancer screening through randomized controlled trials and other methods. The document summarizes CitiScreen's goal of comprehensive cancer screening through a combination of technologies and outlines screening patterns for specific cancers like breast, ovarian, lung, and colorectal cancer.
On February 21, 2020, at Codogno Hospital (in the Lodi?s Province, Lombardy, Italy), Italy?s Coronavirus ?patient one? was discovered. In the following week the cases within the Province of Lodi increased exponentially and it was interpreted as a disease cluster originating from the hospital.
COVID-19 is a new strain of Coronaviruses virus declared by the World Health Organization (WHO) as a pandemic on March 11th, 2020. While the majority of patients with COVID-19 typically have characteristic respiratory presentations subsequently
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Despite better understanding of Multiple Myeloma (MM) and the development of novel therapeutic strategies which improved overall survival, MM still remain largely incurable. This warrants a better understanding of socio-demographic factors that may influence disease course and outcomes across MM patient
A 43-Year-Old Male with PCM1-JAK2 Gene Fusion Experienced T-Lymphoblastic Lym...AnonIshanvi
Myeloid/lymphoid neoplasms associated with eosinophilia and PCM1-JAK2 is a provisional entity in WHO 2016. Prior case reports have shown quite a few clinical presentations in different patients with this chromosome translocation,characterized by eosinophilia in combination with myelodysplastic/ myeloproliferative neoplasms, acute myeloid leukemia(AML) and rarely, T-lymphoblastic lymphoma(T-LBL) or B-acute
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The rate of Helicobacter pylori (H. pylori) infection is higher in minority patients in the United States [1]. Gastric intestinal metaplasia (IM) is associated with H. pylori infection and carries an increased risk for gastric cancer over time, in particular for patients from regions of high gastric cancer incidence [2]
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Postpartum Meningitis by Enterococcus Faecalis Secondary to Neuraxial Anesthesia
1. Annals of Clinical andMedical
Case Reports
ISSN 2639-8109
Research Article
Preliminary Results of Fecal Microbiota Transplantation in
Diarrhea-Predominant Irritable Bowel Syndrome: Case Series
on 12 Patients
Cha B1#
, Hong J2#
, Jin-Seok P1
*, Ko W1
, Shin YW1
1
Department of Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic
of Korea
2
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
#
Boram Cha and Jitaek Hong both contributed equally to this work and share first authorship
Volume 4 Issue 1- 2020
Received Date: 07 Apr 2020
Accepted Date: 14 May 2020
Published Date: 19 May 2020
2. Keywords:
Fecal Microbiota Transplantation;
Irritable Bowel Syndrome; Diarrhea
1. Abstract
1.1. Background and Aims: IrritableBowelSyndrome(IBS)isassociatedwithintestinaldysbiosis
and it has been suggested Fecal Microbiota Transplantation (FMT) has a positive effect on the
condition. In this preliminary study, we recruited 12 IBS patients with moderate to severe diarrhea
(IBS-D) and assessed the clinical outcomes of single FMT.
1.2. Materials and Methods: Patients underwentaclinicalassessmentto determinecompliance,
symptoms, and safety at baseline and at 1, 3, and 6 months after FMT. At these visits, patients
submitted self-reports on stool form/frequency and completed IBS severity score (IBS-SSS), Bir-
minghamIBSsymptomscore,and submitted IBS-QualityofLife(IBS-QOL)questionnaires.Fecal
samples were collected from patients before and after FMT.
1.3. Results: Meanageofthe12studysubjectswas54.2±12.5yearsand58%(7/12)weremen,and
the predominant complaint of all the participated patients was diarrhea. Baseline of mean IBS-SSS
and mean total Birmingham score was 261 and 42.2. Ten patients showed significant improve-
ment compared to baseline IBS severity score, from a mean 259 to 127.5 points at 3 months after
FMT (p<0.05). According to the Birmingham IBS symptom scale, total scores including abdomi-
nal pain and diarrhea were significantly reduced at 1 and 3 months after FMT (p<0.05).
1.4. Conclusion: In this preliminary study,FMTwas found to provide significantIBS-D symptom
relief over 6 months.
3. Abbreviations: IBS:IrritableBowelSyndrome;GI:Gastroin-
testinal; FMT: Fecal Microbiota Transplantation; CID; Clostridi-
um Difficile Infection; IBS-D: Diarrhea-Predominant IBS; IBS-C:
Constipation-Predominant; IBS-M: Mixed IBS; IBS-SSS: IBSSe-
verity Symptom Scale; HIV: Human Immunodeficiency Virus;
HBV: Hepatitis B; HCV: Hepatitis C; HAV:Hepatitis A; IBS-QOL:
IBS-Quality of Life
4. Introduction
Irritable Bowel Syndrome (IBS) is the most commonly diagnosed
gastrointestinal (GI) condition and affects up to 10-15% of the
adult population [1]. IBS has a serious impact on quality of life,
productivity, and social functioning and places a high cost burden
on health care systems [2]. Unfortunately, despite advances in our
understanding of the pathophysiology of IBS, no treatment is avail-
*Corresponding Author (s): Park Jin-Seok, Department of Internal Medicine, Inha University
Hospital, 27 Inhang-ro, Jung-gu, Incheon, 400-711, Republic of Korea, Tel: +82-32-890-2548,
Fax: +82-32-890-2549, E-mail: pjsinha@naver.com
http://www.acmcasereport.com/
able that specifically targets IBS though an algorithm has been con-
structed to guide practicing clinicians who encounter this disorder
[3]. Current evidence suggests that microbiota of the GI tract could
be a significant factor in the etiology of IBS [4], and changes in
the intestinal environment have been suggested to induce compo-
sitional imbalance in gut microbiota, a phenomenon termed ‘dys-
biosis’, which is associated with IBS[5].
There is a growing interest in Fecal Microbiota Transplantation
(FMT) therapy for various GI disorders, and in non-GI disorders
including Parkinson’s disease, fibromyalgia, and metabolic syn-
dromes associated with altered intestinal microbiota [6, 7]. In par-
ticular, FMT has been hugely successful for the treatment of Clos-
tridium Difficile Infection (CDI) [8] and has a much higher cure
rate than antibiotic treatment [9]. Furthermore, studies indicate
FMT restores intestinal microbial balance [10,11].
Citation: Jin-Seok P, Preliminary Results of Fecal Microbiota Transplantation in Diarrhea-Predominant
Irritable Bowel Syndrome: Case Series on 12 Patients. Annals of Clinical and Medical Case Reports. 2020;
4(1): 1-6.
3. Volume 4 Issue 1-2020 ResearchArticle
visual analog scale from 0 to 100 and summing the results [15]. The
second primary end point was stool consistency was assessed using
the Bristol Stool Form Scale. The third was safety end points which
were adverse events during FMT and follow-up, for example, ab-
dominal pain, diarrhea, nausea, vomiting, bloating, and flatulence.
The secondary end points were Birmingham IBS symptom scores
before and 1, 3, 6 months after FMT. The Birmingham IBS symp-
tom score questionnaire is a self-completed questionnaire that con-
tains 11 questions that address the frequency of IBS-related symp-
toms. Each question is rated using a 6-point Likert scale ranging
from 0 = none of the time to 5 = all of the time [16]. The second
is IBS-Quality of Life (IBS-QOL) Questionnaire Scores which is a
34-item instrument developed and validated for the measurement
of patient health-related quality of life [17]. The third is numbers of
doctor appointments or emergency room visits made for the treat-
ment of uncontrolled IBS symptoms, and the forth is number of
new medications initiated for the treatment of uncontrolled IBS
symptoms. Data were collected using daily patient diaries and by
telephone follow-up.
Figure 1: A Flow diagram illustrating the study design
Table 1: General characteristics of 12 patients
Variables (n=12) No. of cases (%)
Age (years)
Mean ± SD, range 54.2 ± 12.5 33-70
Gender, n (%)
Male 7 -58.3
Female 5 -41.7
BMI
Mean ± SD, range 24.5 ± 4.1 17.3-30
Predominant bowel habit, n (%)
Diarrhea 12 -100
Constipation/Alternating/Unsubtype 0 0
Smoking, N (%)
Non-smoker 5 -41.7
Former smoker 5 -41.7
Smoker 2 -16.7
Duration of IBS symptoms, n (%)
1-5 years 9 -75
>5 years 3 -25
IBS-SSS (Max score 500)
Mean SD
250 -79.2
IBS symptoms (Birmingham Score Max score 100) Mean SD
Constipation 0.15 0.5
Diarrhea 38.2 13.2
Pain 49.2 26.2
Total 57.9 10.1
Stool frequency (Stools per day)
Mean SD
5.8 -0.9
Stool consistency (from Bristol stool form)
Mean SD
5.5 -0.66
Concomitant drug, n (%)
Probiotics 11 -91.7
Antispasmodic 10 -83.3
Antidiarrheal 7 -58.3
Anti-depressants 4 -33.3
Severe complication & expire, n (%) 0 0
Abbreviations:BMI;BodyMassIndex,IBS;IrritableBowelSyndrome,IBS-SSS;IBS-SeveritySymptomScale
5.7. Statistics
Continuous data are presented as means ± SDs, and categorical
data as n (%). Statistical analyses of changes in total scores and
subscores versus baseline were performed using the paired t-test
or Wilcoxon’s signed-rank test. The analysis was performed using
SPSS software (version 19.0; SPSS Inc., Chicago, IL), and p values
of <0.05 were consideredsignificant.
5.8. Ethics
Written informed consent, which included laboratory screening
requirements, was obtained from all 13 study subjects prior to
study commencement, and the study was approved by the Insti-
tutional Review Board of Inha University Hospital (2016-04-009).
6. Results
6.1. Patients’ Characteristics
During the study period, 13 patients with IBS-D were enrolled.
However, one patient was lost to follow-up after FMT, did not un-
dergo 4-week evaluation, and was excluded from the results and
the analysis. Consequently, 12 patients completed pre- and post-
FMT evaluations. Patient characteristics are shown in Table 1.
Mean age of the 12 study subjects was 54±12.5 years and 58% were
men. Most of the study subjects complained of diarrhea and 16.7%
were current smokers. Symptom durations were <5 years in 75%
and >5 in 25%. Mean IBS-SSS score was 250±79.1 and mean Bir-
mingham IBS symptom score was 57.9±10.1. Mean stool frequen-
cy was 5.8±0.9 times per day, and mean stool consistency accord-
ing to the Bristol stool form scale was 5.5. No patient experienced
a mortality-associated complication.
6.2. The outcomes of FMT onIBS
A comparison between the pre- and post-FMT IBS-SSS of all
study subjects demonstrated significant reductions compare base-
line (250.0±79.2) to weeks 4 (138.3±100.7) (p<0.05), 12 (125.8
±88.7) (p<0.01), and 24 (124.2 ±91.8) (p<0.01) (Figure 2). Mean
stool consistency scores tended to improve after FMT; pre-FMT
(5.5±0.7), week 4 (4.3±1.0), week 12 (4.2±0.9), and week 24
(4.2±0.9) (p<0.001).
There were no severe nor obvious adverse events after the endo-
scopic procedure, FMT, or during the 6-month follow-up period.
The most common symptom was flatulence (33%, 4/12), but this
disappeared within the first 4 weeks. Three patients experienced
abdominal bloating and one patient borborygmus, but all recov-
ered within 4 weeks. One patient, whose symptoms were well con-
trolled without adding new drugs, visited the emergency room
with abdominal pain 5 months after FMT. Abdominal computed
tomography and blood tests showed non-specific findings. Symp-
toms improved after conservative treatment at home and no symp-
tom recurrence subsequently occurred.
http://www.acmcasereport.com/ 3
4. Volume 4 Issue 1-2020 ResearchArticle
http://www.acmcasereport.com/ 4
FMT also reduced the severity of diarrhea. Mean stool frequencies
decreased from 5.8 per day pre-FMT to 3.5 per day at 4 weeks,
3.2 at 12 weeks, 2.9 at week 24 post-FMT (p<0.001). Mean Bir-
mingham IBS symptom scores were also significantly decreased
at week 4 (13.4±6.2), week 12 (13.8±7.2), and week 24 (14.7±8.7)
as compared with baseline score (23.2± 5.6) (p<0.01) (Figure 3).
According to IBS-QOL scores (Figure 4), IBS-D patients showed
greater impairments on dysphoria, body image, food avoidance,
and relationship subscales than the rest of subscales before FMT
treatment. After 4, 12, and 24 weeks, the mean scores of IBS-QOL
total revealed significant decreased over time compared to the
baseline (Table 2).
There were no unplanned doctor appointments for uncontrolled
symptomsofIBS.Nopatientsstartednewmedicationforthetreat-
ment of uncontrolled IBS symptoms.
Figure 2: Changes of pre-FMT and post-FMT IBS-SSS over 24 weeks
Figure 3: Changesofpre-FMTandpost-FMTBirminghamIBSsymptomscaleover
24 weeks
Figure 4: Changes of pre-FMT and post-FMT IBS-QOL subscale score
7. Discussion
In current study, we found that FMT is an effective treatment for
refractory IBS-D. Stool consistencies were significantly improved
compared to 24 weeks post-FMT, and IBS-SSS, Birmingham IBS
symptom, and IBS-QOL scores revealed significant improvements
at 1, 3, and 6 months (p<0.01) after FMT.
FMT is in generally considered to be safe and its side effects have
been reported to be mild, self-limiting, and GI in nature [18].
However, the safety of FMT has been mainly studied in the context
of CDI, and little information is available regarding the safety of
FMT for the treatment of functional GI disease [19, 20]. Recently,
in a long-term follow-up study of 13 patients who underwent FMT
for refractory IBS, only 1 patient experienced a transient increase
in flatus. Over an average follow-up of 11 months, there were no
long-term side effects, and none of the patients developed any new
disease [20]. Similar to our present study, there were no severe ad-
verse events after FMT but only minor symptoms of abdominal
pain, bloating (2/12), flatulence (3/12), and borborygmus (1/12)
were recorded during follow-up, and even these minor symptoms
diminished shortly after FMT. Our results indicate that FMT may
be considered a safe treatment for IBS-D and is well tolerated.
The effect of FMT on IBS-D symptom relief has not been main-
tained for a long time and 2 patients of IBS-D symptoms regressed
to their pre-treatment states by 1 month after FMT and complained
of diarrhea and abdominal pain. Similar result was reported in a
Danish study [19] of 6-month follow-up study on 52 adult patients.
IBS-D symptom relief by FMT was peaked at 1 month post-FMT
and remained at this level after 3 and 6 months post-FMT. How-
ever, IBS-SSS and IBS-QOL scores did not improve significantly
after 1-month post-FMT. Based on these results, multiple sessions
5. Volume 4 Issue 1-2020 ResearchArticle
http://www.acmcasereport.com/ 5
of FMT might be needed to enhance the efficacy of FMT on IBS-D
since transplanted intestinal bacteria may not permanently colo-
nize the intestine of IBS-D patients. However, multiple sessions of
FMT have not been studied yet and only a trial of multiple FMTs
has been reported that is effective in the treatment of recurrent
CDI [21, 22]. Therefore, well-designed clinical trials are required
to establish the effectiveness of multiple session of FMT on IBS-D.
Several limitations of the present study require consideration. First,
though a prospective study, it was performed only in 12 patients,
which could have resulted in selection bias. Second, no placebo
control group was included for comparison. Third, follow-up was
conducted for only 6 months, and thus, we suggest further long-
term study be conducted. In spite of small number of patients, the
Table 2: Changes of pre-FMT and post-FMT IBS-QOL score
marked clinical improvements observed after FMT warrant further
investigation to clarify the contribution made by fecal microbio-
ta to the etiology of diarrhea. Fourth, clinical improvements were
based on patient`s subjective self-reports and no objective indica-
tors such as measures of microbiota diversity were included. We
chose colonoscopy as the method of FMT administration, because
in a previous meta-analysis, a forest plot of randomized controlled
trials of FMT in IBS generally showed better results for this route
or nasogastric tube administration than for oral FMT capsule ad-
ministration [23]. However, no study has yet directly compared the
effects of FMT capsule and endoscopicadministration.
We conclude that FMT may improve the symptoms of IBS-D until
6 months after FMT. However, the effects of FMT seem to decrease
over time, which raises consideration of booster administrations.
Visit IBS-QOL score
(n=12)
Total Dysphoria
Interference Body Health
Food Avoidance
Social
Sexual Relationship
With Activity Image Worry Reaction
Week 0
49.3
38.5 (19.00)
59.2
46.9 (17.58) 52.8 (13.91) 45.1 (17.93) 53.1 (16.96) 60.4 (14.91)
46.6
-16.44 -17.13 -19.26
Week 4
72.3
67.2 (25.58)
80.1
69.3 (23.15) 70.8 (18.63) 67.4 (16.07) 75.5 (23.61) 76.0 (16.39)
71.5
-20.27 -16.92 -20.86
Week 12
74.8
68.8 (23.00)
83
74.0 (21.95) 72.9 (19.17) 70.1 (16.84) 78.6 (20.89) 77.1 (12.87)
72.2
-17.94 -13.72 -18.23
Week 24
74.9
71.1 (24.39)
83.3
71.4 (21.89) 71.5 (17.21) 68.1 (15.82) 78.6 (21.89) 78.1 (13.19)
73.6
-18.61 -15.25 -18.75
Change from week
0 to 4
74.9
28.6 (18.88)*
20.8
22.4 (16.95)** 18.1 (14.14)*** 22.2 (14.79)*** 22.4 (19.12)*** 15.6 (15.19)
25
-18.61 (13.44)* (19.13)**
Change from week
0 to 12
23 30.2 23.8
27.1 (21.38)*** 20.1 (18.62)*** 25.0 (19.46)** 25.5 (21.06)** 16.7 (15.39)
25.7
(14.81)* (22.31)** (16.00)* (21.16)**
Change from week
0 to 24
25.6 32.6 24.1 24.5 18.7 22.9 25.5 17.7 27.1
(19.67)** (25.55)** (20.15)*** (24.05)*** (17.09)*** (18.84)** (21.40)*** (14.56)** (21.65)**
Abbreviations: IBS; Irritable Bowel Syndrome, IBS-QOL; IBS-Quality of Life
IBS-QOL score, *: p<0.001, **: p=0.001, ***: p<0.01
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