A research group at Kagawa University has succeeded in treating a child with refractory bacterial enteritis by transplanting her father's feces into her intestines. Even after one year had passed since the transplantation, no recurrence or complications were observed. Although fecal transplantation is performed for certain diseases overseas to normalize intestinal microbiota, there are not many cases in Japan because it is not covered by health insurance. Going forward, they aim to accumulate cases and establish it as a treatment option.
A research group including Assistant Professor Takeo Kondo (Gastroenterology and Hepatology) of the Department of Medicine Pediatrics at Kagawa University School of Medicine treated a 3-year-old girl who developed enteritis with diarrhea as the main symptom, known as refractory recurrent Clostridioides difficile (CD) enteritis. Because this girl experienced recurrences even when administered antibacterial drugs specified in guidelines, they explored other treatments.
This girl was born with an extremely low birthweight, and for a while after birth, underwent intensive care under medical management. Although she was able to be discharged later, complications existed in her heart and lungs, and she was urgently hospitalized due to the conditions worsening. While undergoing treatment in the ward, abdominal pain and diarrhea were observed.
While the main symptom of CD enteritis is diarrhea, there are complaints similar to other digestive diseases such as fever and abdominal pain. Bacterial tests were performed for differential diagnosis, and these digestive symptoms were ultimately found to be caused by CD enteritis. However, although treated for CD enteritis according to guidelines, the condition recurred multiple times upon stopping treatment, resulting in a condition difficult to cure completely.
Regarding the reason CD enteritis recurred repeatedly and became refractory, Kondo analyzed as follows: "In addition to using antibacterial drugs after birth, having heart and lung complications as an extremely low birthweight infant led to receiving uniform nutrition via long-term nasogastric nutrition, which may have brought about a decrease in the diversity of intestinal bacteria, and that might be one factor for it becoming refractory."
Seeing no recovery even when administering oral antibacterial drugs, they decided to perform a fecal transplantation. Collecting stool from her biological father who was in good health, the stool dissolved in saline to a liquid state, filtered with a sterile gauze and adjusted to a volume of 150 cubic centimeters. Using a colonoscope, it was transplanted into the girl's colon. After transplantation, the bacterial environment inside the colon became well-regulated. No recurrence or complications were observed even one year later.
Reporting this method at two pediatrics-related academic conferences in September 2025 and April 2026, other pediatricians stated, "We have similar patients and are troubled by the lack of treatment methods. We want you to explain specific transplantation procedures."
Kondo stated: "Even at Kagawa University Hospital, there are two or three onset cases of CD enteritis per year. Although the frequency is low, among them, when following a refractory course like this child, fecal transplantation comes up as an option. From ethical viewpoints and other factors, it cannot be implemented at any medical institution under current circumstances, but we want to increase cases and establish the treatment method so that complete cures are possible."
Original article was provided by the Science Portal and has been translated by Science Japan.