Combined butyric acid/mesalazine treatment in ulcerative colitis with mild-moderate activity. Results of a multicentre pilot study.

AIM The short-chain fatty acid, acetate, propionate and butyrate are end products of fermentation by intestinal microflora of the indigestible material, mainly carbohydrates, reaching the colon and are essential for the vital function of the colonic cells. Butyric acid furnishes energy to the cells of the colon and may play an anti-inflammatory role in pathologies of large bowel. Low concentrations of butyrate and of short-chain fatty acids have been found in the colon of patients with ulcerative colitis and this may justify therapy with butyrate and mesalazine in this disease. The aim of the paper was to evaluate the efficacy of treatment with butyric acid and mesalazine in reducing relapse of mild to moderate ulcerative colitis in affected patients. METHODS An open study was conducted by 19 Italian Gastrointestinal Units, forming part of the GISDI study Group, in 216 patients with ulcerative colitis who showed an incomplete response to standard mesalazine treatment. The treatment proposed is mesalazine (800 mg x3) + 3 butyrate 0.3 g + 0.250 inulin tablets, in a formulation resistant to intestinal absorption (ZACOL NMX, Bioactival). RESULTS The results obtained indicate that the addition of 3 tablets/die of ZACOL-MNX is effective in reducing disease activity, with a marked improvement of symptoms and in the endoscopic appearance of mucosa. CONCLUSION These findings prompt a further double-blind investigation to better define the efficacy of the proposed treatment.