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.