COLONIC PRODUCTION OF BUTYRATE IN PATIENTS WITH PREVIOUS COLONIC-CANCER DURING LONG-TERM TREATMENT WITH DIETARY FIBER (PLANTAGO-OVATA SEEDS)

Background: Butyrate has antineoplastic properties against colorectal cancer cells and is the preferred oxidative substrate for colonocytes. Like acetate and propionate (short-chain fatty acids; SCFAs), butyrat e is produced by colonic fermentation of dietary fibre. Methods: Twent y patients resected for colorectal cancer were treated with 20 g/day o f the fibre Plantago ovata seeds for 3 months, which increased the int ake of fibre by 17.9 +/- 0.8 g/day, from basal levels of 19.2 +/- 1.7 g/day; 17 patients completed the study. Faecal samples were obtained o n eight occasions, twice before treatment, and monthly three times dur ing and three times after treatment. Results: One month of fibre thera py increased faecal concentrations of butyrate by 42 +/- 12% (from 13. 2 +/- 1.2 to 19.3 +/- 3.0.mmol/l; P < 10(-4)), acetate by 25 +/- 6% (P < 10(-4)), propionate by 28 +/- 9% (P = 0.01), and total SCFAs by 25 +/- 6% (P < 10(-4)). Concentrations were increased during the 3-month fibre treatment but reversed to pretreatment levels within 1 to 2 mont hs after cessation of fibre supplementation. The relative concentratio n (ratio) of butyrate was not altered owing to a simultaneous increase in acetate and propionate. Faecal pH decreased initially but was norm alized after 2 months of fibre supplements. Fibre therapy increased th e 24-h productions of butyrate by 47 +/- 10% (P < 10(-4)) and acetate by 50 +/- 7% (P < 10(-4)) in 16.6% faecal homogenates with added P. ov ata seeds (20 mg/ml), but SCFA productions returned to pretreatment le vels after discontinuation of additional fibre intakes. Conclusions: O ral intake of P. ovata seeds adapted the colonic flora to increase the production of butyrate (and acetate) from this fibre and increased fa ecal concentrations of butyrate by 42% in patients resected for coloni c cancer. The effects depended on continuity of treatment.