[Faecal lactate as a disease activity index of ulcerative colitis: application to assessment of efficacy in the treatment with total parenteral nutrition].

I investigated changes of faecal short-chain fatty acids (SCFA) in 52 hospitalized patients with ulcerative colitis (UC) who had bloody diarrhoea (severe and moderate colitis). The results suggest that molar ratios of faecal lactate could be helpful to monitor the disease activity of UC patients. Faecal SCFA output correlated directly with faecal output. This finding reflected an increase in output of lactate and acetate. In severe colitis, concentrations of faecal lactate were increased, whereas those of faecal major components of SCFA (acetate, propionate and n-buty-rate) were markedly reduced. Further, faecal lactate concentrations were increased in cases with bloody diarrhoea and reduced in those with formed stool. Patients were divided into two groups according with their treatments: patients treated with total parenteral nutrition (TPN) or low-residue UC diet. The molar ratio of faecal lactate in the TPN group was reduced below 2% in four weeks, whereas that in the UC diet group was reduced into the 2% mark in eight weeks. These findings support that patients in the former group were more rapidly induced into remission.