Treatment of ulcerative colitis with fish oil supplementation: a prospective 12 month randomised controlled trial.

Abstract

The effect offish oil on the course ofulcerative colitis was investigated in a randomised blinded controlied study. Eighty seven patients received supplements of 20 ml HiEPA fish oil as triglyceride (4.5 g of eicosapentaenoic acid) or olive oil placebo daily for one year. The oils were given in addition to standard drug therapy and trial entry was stratified for disease activity. Fish oil significantly increased the eicosapentaenoic acid content of rectal mucosa to 3.2% of total fatty acids at six months, compared with 0.63% for patients on olive oil. This was associated with increased synthesis of leukotriene B5, and 53% suppression of leukotriene B4 synthesis by ionophore -stimulated neutrophils. Leukotriene B4 suppression persisted for at least two months after treatment was stopped. Treatment with fish oil resulted in measurable, but only limited clinical benefit. For patients entering the trial in relapse (n=53), there was a significant reduction in corticosteroid requirement after one and two months treatment. There was a trend towards achieving remission (off corticosteroids) faster in the patients on fish oil, although differences were not significant. For patients in remission at trial entry or during the trial (n=69), there was no significant difference in the rate of relapse by log rank analysis. We conclude that fish oil supplementation produces a modest corticosteroid sparing effect in active disease, but there is no benefit in maintenance therapy.

Potential of Magnetic Resonance Spectroscopy in Assessing the Effect of Fatty Acids on Inflammatory Bowel Disease in an Animal Model

“…observed that the levels of unsaturated fatty acids, EPA and DHA increased in rectal mucosa after ω-3 PUFA supplementation (34). A similar effect on colonic fatty acid profile was seen by…”

Marine oils: metabolic effects and role in human nutrition

“…The first trial, which was an open study, showed no benefit whereas the latter two studies, which were larger, better controlled and used higher doses, showed mild to moderate symptomatic improvement. Hawthorne et al (1992) reported mild clinical benefit and decreased requirement for corticosteroids in a double-blind controlled trial of fish oil in colitis.…”

Intestinal responsiveness to experimental colitis in young rats is altered by maternal diet

“…Consistent with this, the low incidence of IBD among the Inuit has been attributed to their habitual high intake of n-3 fatty acids, particularly eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3) from marine foods (6). High dietary intakes of n-3 fatty acids have also shown therapeutic benefit in experimental models of colitis (1,36,37,49) and in several clinical studies including patients with ulcerative colitis and Crohn's disease (4,7,18,45). The absence of significant therapeutic efficacy in some clinical trials of n-3 fatty acids in patients with IBD (31,33) may be explained by differences in study design, patient selection, and the formulation, dose, and duration of n-3 fatty acids (6).…”