Short-Chain Fatty Acid Irrigation in Severe Pouchitis

Abstract

To the Editor: Pouchitis (acute inflammation of the mucosa of the ileal reservoir) is a major long-term complication of restorative proctocolectomy.¹ Little is known about its pathogenesis or the efficacy of medical treatment. No controlled therapeutic trials have yet been performed.¹ Concentrations of short-chain fatty acids are lower in pouch effluent than normal stool,² and an inverse correlation has been found between pouch concentrations of butyrate and the degree of villous atrophy.³ It has been suggested that this reduction in the level of the short-chain fatty acids in the pouch may enable the growth of enteropathic bacteria that produce toxic . . .