Fecal excretion of short-chain fatty acids as a marker of the severity of ulcerative colitis

Abstract

Aim. to determine the fecal excretion of short-chain fatty acids (SCFA) in patients with active ulcerative colitis (UC) depending on the duration, activity, and severity of the disease. Subjects and methods. The study enrolled 53 patients, including 9 patients with proctosigmoiditis, 18 with left-sided colitis, and 26 with total colonic lesion. The total levels of metabolites, the concentrations of acetic, propionic, and butyric acids in the feces were measured by gas liquid chromatography. Results. Comparison of the excretion of bacterial metabolites with the clinical activity index (CAI) and the endoscopic activity index (EAI) revealed that the level of bacterial metabolites increased with an EAI of 21-30 scores and a CAI of 9-12 scores and then drastically decreased with excess of these values (a group of patients with total colonic lesion). With an EAI of less than 20 scores, the total level of metabolites was 8.91 ± 1.027 mg/g. It rose steeply up to 17.12 ± 1.55 mg/g in the activity range of 21 to 30 scores, but dropped up 5.291 ± 0.916 mg/g when the EIA was more than 31 scores. The more severity of UC by the CAI resulted in a reduction in the total level of the metabolites from 12.84 ± 2.039 to 5.114 ± 1.186 mg/g. Conclusion. SCFA deficiency caused by impaired synthesis occurs only in severe total UC. In patients with UC, fecal SCFA excretion increases with the longer duration of an inflammatory process and with its higher activity.

Keywords

• ulcerative colitis
• short-chain fatty acids