Local short-chain fatty acids supplementation without beneficial effect oninflammation in excluded rectum

Background: Rectal instillation of short-chain fatty acids (SCFA), importan t nutrients for the colorectal mucose, has been suggested to be of therapeu tic value in distal intestinal inflammation. Methods: In this study nine pa tients with Hartmann-closed rectum after colectomy for acute colitis were i nvestigated. In a double-blind crossover trial an enema containing SCFA or a placebo solution was administered twice daily for 3 weeks. Before entry i nto the protocol, after each treatment period, and 6 weeks after the study period the patients' symptoms were evaluated, rectal endoscopy was performe d, histologic samples were scored, and microbiologic analyses were carried out. Results: No significant differences in symptoms, in mucosal inflammati on, in histologic scoring, or in microbiologic studies were found between S CFA and placebo periods. Unexpectedly, all but one patient entirely lacked coliform bacteria in the rectum. Conclusions: In this study SCFA enemas had no beneficial effect on inflammation in excluded rectum in patients earlie r submitted to colectomy for colitis. However. a different rectal flora was detected in these patients.