Fecal microbiota transplantation for chronic constipation following bowel surgery in an elderly patient: A case report

Rationale: Chronic constipation is a common gastrointestinal disorder traditionally managed with laxatives and surgical interventions. Nevertheless, a subset of elderly patients remains unresponsive to conventional treatments. Additionally, chronic constipation is linked to an increased risk of mortality from cardiovascular events and a heightened incidence of colorectal cancer. Patient concerns: A 65-year-old male with a medical history of sigmoidostomy, enterostomy, and jejunostomy presented with an 11-year history of intermittent abdominal distension, pain, and constipation refractory to standard treatments including lactulose, castor oil, and glycerin enemas. Diagnoses: The patient was diagnosed with severe chronic constipation associated with surgically altered anatomy and intestinal dysbiosis. Interventions: After thorough discussion, fecal microbiota transplantation (FMT) was implemented as a therapeutic intervention. Outcomes: The patient’s abdominal distension and pain were significantly alleviated within 1 week and completely resolved 6 months post-FMT. No recurrence was observed during the subsequent follow-up period. Lessons: This case demonstrates that FMT can serve as an effective therapeutic intervention for elderly patients with surgically altered anatomy and intestinal dysbiosis, particularly those showing reduced response to conventional laxative treatments for chronic constipation.