Hallert Claes, Björck Inger, Nyman Margareta, Pousette Anneli, Grännö Christer, Svensson Hans
Department of Internal Medicine, Vrinnevi Hospital, Norrköping, Sweden.
Inflamm Bowel Dis. 2003 Mar;9(2):116-21. doi: 10.1097/00054725-200303000-00005.
Topical butyrate has been shown to be effective in the treatment of ulcerative colitis (UC). Butyrate is derived from colonic fermentation of dietary fiber, and our aim was to study whether UC patients could safely increase the fecal butyrate level by dietary means. We enrolled 22 patients with quiescent UC (mean age, 44 years; 45% women; median time from last relapse, 1 year) in a controlled pilot trial lasting 3 months. The patients were instructed to add 60 g oat bran (corresponding to 20 g dietary fiber) to the daily diet, mainly as bread slices. Fecal short-chain fatty acids (SCFAs) including butyrate, disease activity, and gastrointestinal symptoms were recorded every 4 weeks. During the oat bran intervention the fecal butyrate concentration increased by 36% at 4 weeks (from 11 +/- 2 (mean +/- SEM) to 15 +/- 2 micromol/g feces) (p < 0.01). The mean butyrate concentration over the entire test period was 14 +/- 1 micromol/g feces (p < 0.05). Remaining fecal SCFA levels were unchanged. No patient showed signs of colitis relapse. Unlike controls, the patients showed no increase in gastrointestinal complaints during the trial. Yet patients reporting abdominal pain and reflux complaints at entry showed significant improvement at 12 weeks that returned to baseline 3 months later. This pilot study shows that patients with quiescent UC can safely take a diet rich in oat bran specifically to increase the fecal butyrate level. This may have clinical implications and warrants studies of the long-term benefits of using oat bran in the maintenance therapy in UC.
局部用丁酸盐已被证明对溃疡性结肠炎（UC）的治疗有效。丁酸盐来源于膳食纤维的结肠发酵，我们的目的是研究UC患者是否可以通过饮食方式安全地提高粪便丁酸盐水平。我们招募了22例静止期UC患者（平均年龄44岁；45%为女性；距上次复发的中位时间为1年），进行了一项为期3个月的对照试验。患者被指示在日常饮食中添加60克燕麦麸（相当于20克膳食纤维），主要做成面包片食用。每4周记录一次包括丁酸盐在内的粪便短链脂肪酸（SCFA）、疾病活动度和胃肠道症状。在燕麦麸干预期间，4周时粪便丁酸盐浓度增加了36%（从11±2（平均值±标准误）微摩尔/克粪便增至15±2微摩尔/克粪便）（p<0.01）。整个试验期间丁酸盐的平均浓度为14±1微摩尔/克粪便（p<0.05）。其余粪便SCFA水平未变。没有患者出现结肠炎复发的迹象。与对照组不同，试验期间患者的胃肠道不适没有增加。然而，试验开始时报告有腹痛和反流症状的患者在12周时症状有显著改善，但3个月后又恢复到基线水平。这项初步研究表明，静止期UC患者可以安全地食用富含燕麦麸的饮食，以专门提高粪便丁酸盐水平。这可能具有临床意义，值得对在UC维持治疗中使用燕麦麸的长期益处进行研究。
