Fecal Microbiota Transplantation promotes disease remission in a patient with active Crohn’s disease: A Case Report

Background: A woman aged 46 years presented with moderate to severe Crohn’s disease (CD). Sigmoidoscopy revealed proctitis, with Harvey-Bradshaw Index (HBI)=7. The patient experienced up to six bloody stools per day, stool samples showed increased fecal calprotectin, and low albumin.

Method: Case Report. Therapy with 1 portion fecal microbiota transplantation (FMT) capsules every day as add on treatment for 2 weeks was initiated. Hereafter, FMT therapy was tapered off for 21 weeks and stopped.

Results: The patient achieved disease remission at week 21. From 2020 till 2023, when the patient experienced disease relapses (up till twice a year), the patient was treated with FMT capsules (one portion per day) for 1-2 weeks, which promoted disease remission. At the age of 49, the patient was examined by colonoscopy, blood tests and fecal calprotectin. Endoscopy and biopsies (macroscopic and microscopic) showed mild inflammation around the appendix and anal regions and no inflammation in the remaining part of the colon and ileum. Blood samples and fecal calprotectin collected prior to colonoscopy were normal.

Conclusion: This study suggests that FMT may promote disease remission in CD patients with moderate to severe disease. Microbiome data shows that the patients gut microbiome changed to resemble the donor microbiome. FMT therapy was able to change the intestinal microbiome in a patient with CD accompanied by clinical disease remission.