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Am J Gastroenterol

Title:Treatment of refractory distal ulcerative colitis with short chain fatty acid enemas
Author(s):Patz, J.Jacobsohn, W. Z.Gottschalk-Sabag, S.Zeides, S.Braverman, D. Z.
Address:Department of Gastroenterology and Pathology, Shaare Zedek Medical Center,Jerusalem, Israel.
Year:1996 Apr
Journal Title:Am J Gastroenterol
Page Number:731-4
ISSN/ISBN:0002-9270 (Print). 0002-9270 (Linking)
Abstract: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 < 0.05) and tenesmus (1.6 vs. 0.3, p < 0.05) and by global self-assessment. Endoscopic improvement occurred in five (6.78 +/- 0.83 vs. 4.44 +/- 2.7, p < 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 patients 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.

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