Treatment of refractory distal ulcerative colitis with short chain fatty acid enemas
Patz, J.; Jacobsohn, W.Z.; Gottschalk-Sabag, S.; Zeides, S.; Braverman, D.Z.
American Journal of Gastroenterology 91(4): 731-734
1996
ISSN/ISBN: 0002-9270 PMID: 8677939 Document Number: 466940
Objectives: To determine the efficacy and safety of short chain fatty acids (SCFA) in the treatment of refractory distal ulcerative colitis (UC). Methods: Ten patients with distal UC who had failed to respond to rectal and oral therapy with 5-ASA and corticosteroids were treated with twice daily enemas containing sodium acetate 60 mM, sodium propionate 30 mM, and sodium butyrate 40 mM titrated to a pH of 7. Patients were assessed clinically (rectal bleeding, tenesmus, bowel motions), endoscopically, and histologically before and after 6 wk of therapy. In addition, patients gave a self-assessment of the efficacy of treatment. Results: Five of the 10 patients responded clinically, and four of these had a clinical remission as reflected by a decrease in degree of bleeding (2.2 vs. 1.2, p lt 0.05) and tenesmus (1.6 vs. 0.3, p lt 0.05) and by global self-assessment. Endoscopic improvement occurred in rive (6.78 +- 0.83 vs. 4.44 +- 2.7, p lt 0.05). Histologically, no improvement was noted. No side effects were noted, and no patient's condition deteriorated. Conclusions: In this open-labeled study in padents with highly refractory distal UC, 50% had an overall clinical and endoscopic response. Forty percent of the patients assessed the treatment to be superior to previous treatments and expressed a desire to continue. This trial confirms other studies as to the efficacy of this treatment and further confirms the need for controlled trials of this promising therapy.