Nutrition in Crohn Disease-Butyrate.
Butyrate is a short chain fatty acid produces when healthy bacterial flora digest soluble fiber. Butyrate has long been shown to be effective with many GI disorders because it is the preferred fuel source for the cells lining the colon.
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Butyrate is a short-chain fatty acid produced by bacterial fermentation of dietary fiber and undigested starch in the colon. It is important in maintaining the health and integrity of colonic mucosa,[55] as it provides greater than 70% of the energy supply of the colonocyte.[56] Recently, it was demonstrated that butyrate inhibits the inflammatory response in CD by inhibiting the transcription factor nuclear factor kappa B (NFkappaB) activation in immune cells.[57] NFkappaB is involved in inflammatory and immune responses and regulates TNF. By inhibiting NFkappaB, TNF is downregulated and, theoretically, inflammation will be reduced. Already demonstrated in patients with steroid-resistant CD is marked improvement in those patients treated with monoclonal antibodies to TNF.[58] Although further studies are needed to determine the best method of administering butyrate, it offers promise for an immune modulatory therapy for treating patients with CD. Of note, an oral precursor of butyrate has recently been used in ulcerative colitis and was successful in lowering corticosteroid dose. Further utility in CD might be of special interest.