Ulcerative Colitis. Crohn’s Disease

We use fetal cell suspensions containing stem cells, in comprehensive treatment of patients with nonspecific ulcerative colitis and Crohn’s disease. Transplantation of fetal stem cells is effective in cases of both acute and chronic forms of nonspecific inflammatory bowel diseases of all severity grades, including severe course.

Indications for use of fetal stem cells are as follows:

• progressing disease unresponsive to conservative therapy for 2 weeks;
• presence of extraenteric complications;
• impossibility to carry out surgical intervention due to patient’s severe condition resulting from anemia, hypoproteinemia, profound metabolic disorders;
• exhaustion;
• difficulty finding the same blood group for transfusion, or same group incompatibility between a donor and a recipient detected through compatibility testing.

The table below presents main clinical criteria of treatment efficacy based on 16 years of experience in patients with nonspecific ulcerative colitis and Crohn’s disease.

Symptoms		% of patients experiencing the symptom
		Prior to transplantation	Time after transplantation
			1 month	6 months
Daily stool frequency	3 and less	11.1	85.2	77,8
	4 and more	88.9	14.8	22,2
Stool consistency	formed	3.7	74.1	66,7
	loose or doughy	96.3	25.9	33,3
Pathological admixtures in feces:	mucus	81.5	40.7	29,6
	blood	88.9	37.0	14,8
	purulence	14.8	0.0	3,7
Tenesmus		66.7	14.8	18.5
Abdominal pain		85.2	18.5	29.6
Elevation of body temperature		48.1	11.1	18.5

Treatment of a patient with non-specific ulcerative colitis

According to the patient, the onset of the disease dates back to 2003 when he noticed blood in his feces for the first time. He underwent treatment for hemorrhoids. No improvement in his condition was observed. He reported blood in the feces and frequent defecation. Non-specific ulcerative colitis was diagnosed in the summer of 2006, and he started Sulfasalazin up to 4 g/day, but that treatment didn’t result in significant improvements. In June 2007, worsening of condition was noticed: weight loss by 7 kg, stool frequency up to 12 times a day, semi-liquid feces, blood and pus in stool, general weakness.

12.10.2007 Colonoscopy No. 1 of Patient K. Download (125 Mb)

Findings: Insertion of videocolonoscope into the head of the blind colon showed that mucus of the blind and a part of the ascending colon is pale, vascular patterns is not visualized, but there are multiple inflamed polyps of different shape and size. Inflammation becomes more intense towards rectum: haustra and vascular pattern are absent, while the number and the size of inflamed polyps increase; besides, mucus of this part is hemorrhagic. Biopsy sample was taken from transverse and descending colon.
Impression: Non-specific total ulcerative colitis

Clinical and endoscopic findings confirm total autoimmune damage of the colon. Such patients are on specific anti-inflammatory therapy for years, although it is not always effective, and patients suffer frequent recurrences. Continuous spontaneous hemorrhage exhaust patients, and quite often the above leads to a surgery resulting in worsening of the life quality and even disability.
24.10.07 Patient K. underwent stem cell treatment at the EmCell clinic
He was also prescribed Salofalc (Mesalazine) 500 mg 2 tab t.i.d., Salofalc 500 mg 2 rectal suppositories at night, De-nol 1 tab. q.i.d., Augmentin – 1.2 mg drip-feed intravenously with 0.9% saline solution 100.0 ¹15, Solu Cortef – 200 drip-feed intravenously with 0.9% saline solution 200.0 ¹5, Polcortolon – 4 mg according to prescription, and Diflucan – 150 mg once a week.

Two months after the stem cell treatment Patient K. underwent control colonoscopy. He reported improvement in his condition and absence of weakness. Stool frequency decreased to two times a day, no pus or blood was found in his stool. The patient gained weight, and his weight reached 65 kg. He didn’t show any signs of anemia. He continued specific conventional anti-inflammatory treatment with Salofalc (Mesalazine) in tablets and suppositories up to 4000 mg a day.

23.01.08 Colonoscopy No.2 of Patient K. Download (53 Mb)

Findings: Insertion of videocolonoscope into the head of the blind colon reveals well visualized opening of the appendix. Ileocecal (Bauhin’s) valve is tilted towards the colonic lumen. Mucus of the colon is pale, vascular pattern is visualized, no signs of erosion are observed. Multiple pseudopolyps varying in size in shape are seen all over the colon. Trabecula in sigmoid colon. Hemorrhagic groups of pseudopolyps in transverse colon. Colonoscopy doesn’t show any signs of ulceration of the colon. Impression: Chron’s disease of the colon? Taking into consideration clinical findings and medical history, we can assert that the disease is in remission. As an objective factor, endoscopic findings show that the patient doesn’t have any signs of autoimmune ulceration. Taking into consideration indirect signs, endoscopist suspected Chron’s disease. Five months after the fetal stem cell transplantation, Patient K. underwent control colonoscopy. He reports clinical remission and improved quality of life. Stool – 1-2 times a day, without blood or pus. He keeps to a diet. His body weight increased to 68 kg. He continues conventional anti-inflammatory therapy with Salofalc (Mesalazine) in tablets and suppositories, total dose being reduced to 3000 mg a day. 17.04.08 Colonoscopy No. 3 of Patient Ê. Download (51 Mb) Findings: Insertion of videocolonoscope 10 cm deep into jejunum shows that mucus is velvety and shiny. Multiple pseudopolyps varying in shape and size (0.1-0.4 cm) starting from the caecum, but mucus visualized is unchanged. Beginning from the middle third of the transverse colon, mucus is hyperemic and tender. Number of polyps and their size increase, and in some places polyp clusters exceeding 2-4 cm are found. Hemorrhagic mucus. Impression: Pseudopolyposis. Chron’s disease of colon? Eight months after the fetal stem cell transplantation, Patient K. underwent control colonoscopy. He reported remission, defecation frequency reduced to two times a day, stool being without blood or pus. He keeps to a diet. Stable body weight (68 kg). Specific conventional therapy with Salofalc (Mesalazine) in tablets and suppositories up to 2500 mg a day. 17.07.08 Colonoscopy No. 4 of Patient K. Download (160 Mb) Findings: Videocolonoscope was inserted into the head of the blind colon. Shape of the folds correlates to the parts, but lubricated throughout the height, reduced tone. Multiple polypoid formations with peduncles as well as cup-headed, many of them clustered, in all parts of the colon, more in the left. These formations are hyperemic, their size is from 0.2 to 0.5-0.6 cm in height and diameter. The patient refused biopsy. Endoscopy didn’t confirm either Chron’s disease or non-specific ulcerative colitis. Impression: Family polyposis or pseudopolyposis in ulcerative colitis? Twelve months after the fetal stem cell transplantation, Patient K. underwent the next scheduled control colonoscopy. The patient reports discomfort in the abdomen, defecation frequency is two times a day, stool being without blood or pus. He keeps to a diet. Stable body weight (68 kg). According to the patient, he had a slight exacerbation of the disease due to the wrong food, acute respiratory disease and antibiotic therapy that caused disbacteriosis. He continues specific conventional therapy with Salofalc (Mesalazine) in tablets, the dosage of the medicine being reduced to 1000 mg a day. Exacerbation of the disease and clinical manifestations of disbacteriosis taken into consideration, Patient K. is recommended to undergo the next course of fetal stem cell treatment. 17.10.08 Colonoscopy No. 5 of Patient K. Download (120 Mb) Findings: Videocolonoscope was inserted into the head of the blind colon. Shape of the folds correlates to the parts, but their height and tone are reduced. Multiple polyps sizing 0.2-0.5 cm are found all parts in irregular order. The patient refused biopsy. Impression: Polyposis of all parts of the colon. Family polyposis. Only due to the complex treatment of non-specific ulcerative colitis with both conventional therapy and stem cell suspensions, stable remission, restoration of the immune system competence, termination of the autoimmune reaction against the mucus of the colon was achieved, which lead to the life quality improvement and allowed avoiding the surgical intervention.