Letters to the Editor

nature publishing group

Assessment Of Sexual Function Among Inflammatory Bowel Disease Patients Sultan Mahmood, MD1, Salman Nusrat, MD1, Amber Crosby, APRN1, Yan D. Zhao, PhD2 and Tauseef Ali, MD1 doi:10.1038/ajg.2015.53

Figure 1. Frozen encapsulated stool.

symptoms at day 21. C. difficile PCR was positive and the patient was restarted on vancomycin, with improvement, as a bridge to repeat FMT. The patient subsequently underwent colonoscopic FMT from donor B with a rapid and sustained clinical response at 28 days of follow-up after FMT. Patient 4: A 92-year-old woman with multiple medical comorbidities was referred for rCDI (modified Horn Index 3). Her history included an admission for CDI-associated dehydration. She was treated with metronidazole, complicated by peripheral neuropathy, and four courses of vancomycin with symptomatic recurrence upon discontinuing. She underwent encapsulated FMT using stool from donor B, but experienced recurrence at day 13 of follow-up. Vancomycin was restarted, and she subsequently underwent colonoscopic FMT from donor B with a clinical cure and no adverse events at 38 days of follow-up. This report highlights the role of alternate delivery modalities in FMT nonresponse by colonoscopic or encapsulated routes, and demonstrates that encapsulated FMT was well tolerated in the elderly with comorbidities, and was effective even in colonoscopic FMT failures. Uniquely, this study used standardized, processed stool from the same universal donor for both encapsulated and colonoscopic FMT, with exception of patient 2, minimizing a possible donor effect. We report these findings with caution, as this small study was not controlled nor were the © 2015 by the American College of Gastroenterology

outcomes blinded; however, a significant placebo effect seems unlikely, given the prolonged CDI course in all patients. There is no current consensus on an FMT delivery modality approach; however, as encapsulated FMT emerges, head-to-head studies comparing delivery modality in primary and secondary FMT in rCDI are warranted. CONFLICT OF INTEREST Dr Neil Stollman has received research support from Rebiotix and consulting honoraria from Cubist Pharmaceuticals. OpenBiome is a 501(c)3 non-profit stool bank for fecal microbiota transplantation. REFERENCES 1. Kassam Z, Lee CH, Yuan Y et al. Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis. Am J Gastroenterol 2013;108:500–8. 2. Youngster I, Russell GH, Pindar C et al. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection. JAMA 2014;312:1772–8. 3. Smith M, Kassam Z, Didyk E et al. A scalable workflow for screening, processing and characterizing donor stool for use in fecal microbiota transplantation (Abstract 16). American Gastroenterology Association Freston Conference 2014. 1 East Bay Center for Digestive Health, Oakland, California, USA; 2Massachusetts Institute of Technology, Cambridge, Massachusetts, USA; 3 OpenBiome, Medford, Massachusetts, USA; 4 Broad Institute, Cambridge, Massachusetts, USA. Correspondence: Zain Kassam, MD, MPH, FRCPC, Massachusetts Institute of Technology, Biological Engineering, NE47-379, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA. E-mail: [email protected]

To the Editor: Sexual health is important for a person’s physical, mental, and emotional well-being (1). Inflammatory bowel disease (IBD) is a common group of systemic inflammatory conditions affecting more than 1.5 million people in the United States (2). It is well known that IBD adversely affects the quality of life (3). However, its impact on the sexual functions of patients is not well defined. We conducted a single-center prospective cross-sectional survey of IBD patients seen at the IBD Center at Oklahoma University between June 2013 and June 2014. The primary aim of our study was to assess the sexual function of IBD patients using validated assessment tools and assess the impact of various comorbidities and disease activity on sexual function of IBD patients. Patients completed self-reported questionnaires on basic demographics, the female sexual function index for female sexual function (4), the international index of erectile function for male sexual function (5), patient health questionnaire (6) to measure depression, and the fatigue severity scale (7) to measure fatigue. Disease activity was measured using the modified Mayo score and the Harvey–Bradshaw index for Ulcerative colitis and Crohn’s disease, respectively. SAS software (SAS Institute, Cary, NC) was used for performance of data analyses. Continuous variables were reported as mean±s.d. and categorical variables as percentages. A twosided t-test was used to compare the means of continuous variables, and a χ2 test was used to compare the categorical variables. A P value

Assessment of sexual function among inflammatory bowel disease patients.

Assessment of sexual function among inflammatory bowel disease patients. - PDF Download Free
448KB Sizes 2 Downloads 9 Views