Short-chain fatty acids (SCFA) are formed naturally in the digestive process by microbial fermentation and have been shown to be an essential part of colonic health. SCFAs form through the fermentation of parts of complex carbohydrates that are not well absorbed and serve as fuel for colonic epithelial cells. Diminished levels of SCFAs have been found in patients with certain conditions affecting the colon. That is why short chain fatty acid suppositories have been studied as a pharmacological treatment for diversion colitis, ulcerative colitis, and radiation proctitis. Studies suggest an important role of SCFA in total metabolic health for all individuals.

The three main types of short chain fatty acids found in the colon are acetate, propionate, and butyrate. Many studies have focused on the use of butyrate because it is metabolized first in the colon. While butyrate on its own is effective in many cases, some patients may benefit from a treatment that better mimics the natural composition of SCFAs in a healthy colon. In multiple trials, it has been shown that SCFA infusion results in both clinical and histological improvement. Stool frequency and bleeding ceased for the majority of patients in several placebo-controlled studies.

SCFAs may be mildly effective when taken orally but the majority of them will be absorbed in the small intestine before they reach the colon. This makes rectal dosage forms the preferred method of administration. Although the combination of acetate, propionate, and butyrate for rectal administration has been studied for decades, there is still no commercially available presentation of this medication. However a compounding pharmacy is able to compound SCFA suppositories in customized dosages to meet your needs. Short chain fatty acid suppositories and enemas have helped individuals with colitis and proctitis, especially those that have failed treatment with other medications like mesalamine and corticosteroids.

Articles

Review article: short chain fatty acids in health and disease – Alimentary Pharmacology & Therapeutics

Colonic infusions of short-chain fatty acid mixtures promote energy metabolism in overweight/obese men: a randomized crossover trial. – Scientific Reports (PubMed)