FECAL SHORT-CHAIN FATTY-ACIDS PREDICT DIGESTIVE DISORDERS IN PREMATURE-INFANTS

Background: Excretion of fecal short-chain volatile fatty acids (SCFAs ) may indicate changes in colonic or colonocyte metabolism. The aim of this study was to detect the existence of an average fecal SCFA profi le and to define which changes were associated with clinical events th at occurred during the survey period. Methods: SCFA profiles of 185 st ool samples collected from 46 fed preterm neonates (mean birth weight, 1920 g; mean gestational age, 32.8 weeks) were evaluated and their as sociation with digestive disorders or therapy was explored. Results: T otal SCFA concentration increased from 0 to 80 mu mol/g feces wet weig ht over the first 20 days of life. A basic SCFA profile revealed the e xistence of a highly sensitive period between the second and the third week of life. In the absence of any digestive problem (n = 15), the b utyric acid (C-4) ratio increased from 7% to 24%. Phototherapy (n = 13 ) enhanced the SCFA concentration but decreased the ratios of C-4 and minor acids. Digestive disorders reported included abdominal distentio n (n = 6) or bleeding (n = 8). Only in the case of bleeding was the SC FA profile changed by an enhancement of C-4 by >50%. Antibiotic therap y (n = 3) suppressed SOFA production. Conclusion: This study supports a hypothesis that changes in the SCFA profile could offer a noninvasiv e method to anticipate functional modifications of the gastrointestina l tract before the first clinical signs of pathologic events, includin g necrotizing enterocolitis.