Rationale for the luminal provision of butyrate in intestinal diseases

Short chain fatty acids (SCFA), especially butyrate, play central metabolic roles in maintaining the mucosal barrier in the gut. A lack of SCFA, leading to endogenous starvation of enterocytes, may be the cause of ulcerative colitis and other inflammatory conditions. The main source of SCFA is dietary fibre, but they can also be derived from structured lipids, e.g. tributyrin. Once absorbed by non-ionic diffusion or carrier-mediated anion exchanges, SCFA are either used locally as fuel for the enterocytes or enter the portal bloodstream. Butyrate has been shown to increase wound healing and to reduce inflammation in the small intestine. In the colon, butyrate is the dominant energy source for epithelial cells and affects cellular proliferation and differentiation by yet unknown mechanisms. Recent data suggest that the luminal provision of butyrate may be an appropriate means to improve wound healing in intestinal surgery and to ameliorate symptoms of inflammatory bowel diseases.