Resolution of multiply recurrent and multifocal diverticulitis after fecal microbiota transplantation

Background The exact pathophysiology of diverticulitis is not well understood and may be multifactorial. Recent studies highlight dysbiosis as a plausible mechanism. FMT is a safe strategy to restore commensal colon microbiota and has proven to be an effective treatment for gastrointestinal dysbiosi...

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Bibliographic Details
Published in:Techniques in coloproctology 2020-09, Vol.24 (9), p.971-975
Main Authors: Meyer, D. C., Hill, S. S., Bebinger, D. M., McDade, J. A., Davids, J. S., Alavi, K., Maykel, J. A.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Antibiotics
Clostridioides difficile
Clostridium Infections
Colorectal Surgery
Diverticulitis
Fecal Microbiota Transplantation
Feces
Female
Gastroenterology
Humans
Medicine
Medicine & Public Health
Microbiota
Middle Aged
Proctology
Recurrence
Surgery
Technical Note
Treatment Outcome
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Summary:Background The exact pathophysiology of diverticulitis is not well understood and may be multifactorial. Recent studies highlight dysbiosis as a plausible mechanism. FMT is a safe strategy to restore commensal colon microbiota and has proven to be an effective treatment for gastrointestinal dysbiosis such as Clostridium difficile infection (CDI). There have been no studies reporting the treatment of diverticulitis with FMT. Our aim was to describe the novel application of fecal microbiota transplantation (FMT) for the treatment of recurrent diverticulitis. Case We report a case of a 63-year-old woman who had a 13-year history of multiply recurrent and multifocal diverticulitis previously treated with numerous short courses of intravenous and oral antibiotics for acute flares, two segmental colon resections, and suppressive antibiotic therapy for recurrent disease. Secondary to multiple courses of antibiotics , the patient developed CDI. She was treated with a single round of FMT and subsequently stopped all antibiotics at the time of FMT. Results In 20 months of follow-up, the patient has had no further recurrence of diverticulitis or CDI. Conclusions FMT could prove to be a novel therapy for refractory diverticulitis but requires further investigation.
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-020-02275-w