Ulcerative colitis: the result of an altered bacterial metabolism of bile acids or cholesterol.

It is proposed that in genetically susceptible individuals ulcerative colitis is caused by a bacterial metabolite of bile acids or cholesterol and that this substance is similar or identical to the bacterial metabolites implicated in the development of colon cancer. Since the responsible bacterial reactions may be dependent on vitamin K as an electron acceptor it is suggested that poorly absorbed vitamin K antagonists, specifically alpha-tocopherylquinone, may be capable of inhibiting these reactions and may therefore prove effective in treating ulcerative colitis and in preventing the development of colon cancer.