Abstract
Rectal enemas containing a short-chain fatty acid mixture, butyrate alone, or saline placebo were administered to 47 patients with active distal ulcerative colitis. Enemas were instilled twice daily and the patients' condition was evaluated at entry and after four and eight weeks of local therapy. A disease activity index, chosen as the major end point, decreased significantly after all three modes of treatment with no difference among groups. The endoscopic appearance of the mucosa and the histologic degree of inflammation was not different among groups. After eight weeks, fewer colonic segments were affected endoscopically following butyrate than placebo treatment. This study showed trends towards a beneficial effect of topical short-chain fatty acids in active ulcerative colitis, but more patients are needed to demonstrate this effect with sufficient statistical power.
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References
Cummings JH, Macfarlane GT: The control and consequences of bacterial fermentation in the human colon. J Appl Bacteriol 70:443–459, 1991
Roediger WEW: Metabolic basis of starvation diarrhoea: implications for treatment. Lancet 1:1082–1084, 1986
Roediger WEW: The starved colon—diminished mucosal nutrition, diminished absorption, and colitis. Dis Colon Rectum 33:858–862, 1990
Harig JM, Soergel KH, Komorowski RA, Wood CM: Treatment of diversion colitis with short-chain fatty acid irrigation. N Engl J Med 320:23–28, 1989
Roediger WEW: What sequence of pathogenetic events leads to acute ulcerative colitis? Dis Colon Rectum 31:482–487, 1988
Scheppach W, Bartram P, Richter F: Management of diversion colitis, pouchitis and distal ulcerative colitis.In Physiological and Clinical Aspects of Short-Chain Fatty Acids. JH Cummings, JL Rombeau, T Sakata (eds). Cambridge, Cambridge University Press, 1995, pp 353–360
Breuer RI, Buto SK, Christ ML, Bean J, Vernia P, Paoluzi P, Di Paolo MC, Caprilli R: Rectal irrigation with short-chain fatty acids for distal ulcerative colitis. Preliminary report. Dig Dis Sci 36:185–187, 1991
Senagore AJ, MacKeigan JM, Scheider M, Ebrom JS: Short-chain fatty acid enemas: A cost-effective alternative in the treatment of nonspecific proctosigmoiditis. Dis Colon Rectum 35:923–927, 1992
Vernia P, Marcheggiano A, Caprilli R, Frieri G, Corrao G, Valpiani D, Di Paolo MC, Paoluzi P, Torsoli A: Short-chain fatty acid topical treatment in distal ulcerative colitis. Aliment Pharmacol Ther 9:309–313, 1995
Scheppach W, Sommer H, Kirchner T, Paganelli G-M, Bartram P, Christl S, Richter F, Dusel G, Kasper H: Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis. Gastroenterology 103:51–56, 1992
Steinhart AH, Hiruki T, Brzezinski A, Baker JP: Treatment of left-sided ulcerative colitis with butyrate enemas: A controlled trial. Aliment Pharmacol Ther (in press)
Sutherland LR, Martin F, Greer S, Robinson M, Greenberger N, Saibil F, Martin T, Sparr J, Prokipchuk E, Borgen L: 5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis. Gastroenterology 92:1894–1898, 1987
Thomas L (ed): Labor und Diagnose. Marburg, Medizinische Verlagsgesellschaft, 1991
Sutherland LR, Martin F: 5-Aminosalicylic acid enemas in treatment of distal ulcerative colitis and proctitis in Canada. Dig Dis Sci 32:64S-66S, 1987
Sandborn WJ, Tremaine WJ, Schroeder KW, Batts KP, Lawson GM, Steiner BL, Harrison JM, Zinsmeister AR: A placebo-controlled trial of cyclosporin enemas for mildly to moderately active left-sided ulcerative colitis. Gastroenterology 106:1429–1435, 1994
Roediger WEW: Role of anaerobic bacteria in the metabolic welfare of the colonic mucosa in man. Gut 21:793–798, 1980
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This study was sponsored by Dr. Falk Pharma, Freiburg, Germany.
The study group consisted of the following members: W. Scheppach, H.-P. Bartram, F. Richter, Department of Medicine, University of Würzburg; J.G. Müller, Department of Pathology, University of Würzburg; R. Greinwald, H.-D. Tauschel, Dr. Falk Pharma, Freiburg; M. Gierend, A. Weber, Medicomp GmbH, Ulm; D. Hegemann, Frino Comp, Geretsried; W. Kubetzko, Vitalis-Klinik, Bad Hersfeld; U. Rabast, Elisabeth Krankenhaus, Hattingen; E. Schütz, Gastroenterological Practice, Regensburg; R. Raedsch, St Josefs-Hospital, Wiesbaden; R. Britsch, Gastroenterological Practice, Mannheim; I.H. Rehmann, Gastroenterological Practice, Lippstadt; P. Otto, Krankenhaus Grossburgwedel, Burgwedel; G. Judmaier, Department of Medicine, University of Innsbruck, Austria; A.G. Press, Department of Medicine, University of Göttingen; D. Wördehoff, St. Michael-Krankenhaus, Völklingen; H. Mlitz, Gastroenterological Practice, Saarbrücken; J. Stein, Medical Clinic II, University of Frankfurt; and C. Schmidt, Medical Policlinic, University of Bonn.
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Scheppach, W., German-Austrian Scfa Study Group. Treatment of distal ulcerative colitis with short-chain fatty acid enemas a placebo-controlled trial. Digest Dis Sci 41, 2254–2259 (1996). https://doi.org/10.1007/BF02071409
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DOI: https://doi.org/10.1007/BF02071409