Abstract
Diminished production of short-chain fatty acids (SCFA) by altered flora has been suggested in the pathogenesis of diversion colitis (DC). We evaluated prospectively the effectiveness of SCFA irrigation in 13 patients with excluded colon (eight males, five females; mean age, 48 years). The causes of diversion were inflammatory bowel disease (n=4), colonic cancer (n=2), sigmoid diverticulitis with perforation (n=3), ischiorectal abscess (n=2), and miscellaneous (n=2). Patients were given, twice a day for 14 days in a double-blind manner, a 60-ml enema containing either SCFA (acetate: 60 mmol/liter; proprionate: 30 mmol/liter; and N-butyrate: 40 mmol/ liter) (Group 1; n=7) or isotonic NaCl (Group 2; n=6). Endoscopy with biopsies was performed before starting the trial (D1) and 14 days later (D14). On D1 all patients had endoscopic and histologic findings suggestive of DC. No endoscopic or histologic changes were observed on D14 in either group. We conclude that endoscopic and histologic lesions of DC were not improved by SCFA irrigation during the 14 days.
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References
Glotzer DJ, Glick ME, Goldman H. Proctitis and colitis following diversion of the fecal stream. Gastroenterology 1981;80:438–41.
Roediger WE. Role of anaerobic bacteria in the metabolic welfare of the colonic mucosa in man. Gut 1980;21:793–8.
Neut C, Colombel JF, Guillemot F,et al. Impaired bacterial flora in human excluded colon. Gut 1989;30:1094–8.
Harig JM, Soergel KH, Komorowski RA, Wood CM. Treatment of diversion colitis with short-chain-fatty acid irrigation. N Engl J Med 1989;320:23–8.
Whitehead RH, Young GP, Bhatal PS. Effects of shortchain-fatty acid on a new human colon carcinoma cell line (LIM 1215). Gut 1986;27:1457–63.
Kvietys PR, Granger DN. Effect of volatile fatty acids on blood flow and oxygen uptake by the dog colon. Gastroenterology 1981;80:962–9.
Harig JM, Soergel KH. Treatment of diversion colitis with short-chain-fatty acid irrigation. Gastroenterology 1987;92:1425A.
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A preliminary communication of this work was abstracted in Gut 1989;30:1470 and read at the meeting of the British Society of Gastroenterology, Dublin, Ireland, September 1989.
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Guillemot, F., Colombel, J.F., Neut, C. et al. Treatment of diversion colitis by short-chain fatty acids. Dis Colon Rectum 34, 861–864 (1991). https://doi.org/10.1007/BF02049697
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DOI: https://doi.org/10.1007/BF02049697