Therapeutic use of short-chain fatty acids in colorectal disease.

Short chain fatty acids (SCFA) are produced in the human colon by bacterial fermentation of dietary carbohydrates and fibre polysaccharides and have i mportant physiological functions in the colon. Butyrate is the maim energy- yelding substrate of colonocytes. Low concentrations of SCFA are observed i n the colon in some forms of colitis, suggesting a potential therapeutic ap plication of SCFA in some colonic diseases such as diversion colitis or ulc erative colitis. The results of the first open studies of SCFA enemas in pa tients with ulcerative colitis were promising. Unfortunately recent control led studies with more patients showed clinical efficacy in less than 50% of patients. In diversion colitis, the positive results of the first study we re not confirmed. Clinical trials are still necessary in patients with radi ation proctitis. New clinical studies especially in patients with refractor y colitis seem justified in view of the pathophysiological effects of SCFA.