Dietary supplementation with fish oil in ulcerative colitis.
OBJECTIVE
To determine the efficacy of fish oil supplementation in patients with active ulcerative colitis.


METHODS
Multicenter, randomized, double-blind, placebo-controlled, crossover trail with 4-month treatment periods (fish oil and placebo) separated by a 1-month washout.


METHODS
Four gastroenterology divisions.


METHODS
Twenty-four patients with active ulcerative colitis entered the study. Five dropped out, and one was noncompliant. Eighteen patients completed the study. All patients had active disease as manifested by diarrhea and rectal inflammation.


METHODS
Treatment with prednisone and sulfasalazine was continued. Fish oil supplementation consisted of 18 Max-EPA (eicosapentaenoic acid) capsules daily (eicosapentaenoic acid, 3.24 g; and docosahexaenoic acid, 2.16 g). Placebo supplementation consisted of 18 identical capsules containing isocaloric amounts of vegetable oil.


METHODS
Patients were evaluated at study entry and after each diet period. Evaluations included a review of symptoms, flexible sigmoidoscopy, rectal biopsy, and rectal dialysis to measure prostaglandin E2 and leukotriene B4 levels.


RESULTS
Fish oil supplementation resulted in a significant decrease in rectal dialysate levels of leukotriene B4 from 71.0 to 27.7 pg/mL (average change, -43.3 pg/mL; 95% CI, -83 to -3.6). Significant improvements were seen in acute histology index (average change, -8.5 units from a baseline of 10.5 units; CI, -12.9 to -4.2) and total histology index (average change, -8.5 units from a baseline of 14.80; CI, -13.2 to -3.8) as well as significant weight gain (average weight gain, 1.74 kg, CI, 0.94 to 2.54). No significant changes occurred in any variable during the placebo period. Seven patients received concurrent treatment with prednisone. During the fish oil supplementation period, the mean prednisone dose decreased from 12.9 mg/d to 6.1 mg/d and rose from 10.4 mg/d to 12.9 mg/d during the placebo diet period (P greater than 0.20).


CONCLUSIONS
Four months of diet supplementation with fish oil in patients with inflammatory bowel disease resulted in reductions in rectal dialysate leukotriene B4 levels, improvements in histologic findings, and weight gain.
Stenson
W F
WF
Jewish Hospital of St. Louis, Missouri 63110.
Cort
D
D
Rodgers
J
J
Burakoff
R
R
DeSchryver-Kecskemeti
K
K
Gramlich
T L
TL
Beeken
W
W
D000328:Adult; D003093:Colitis, Ulcerative / Q000178:diet therapy* / Q000378:metabolism / Q000473:pathology; D003956:Dialysis; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D015232:Dinoprostone / Q000378:metabolism; D004281:Docosahexaenoic Acids; D004311:Double-Blind Method; D004338:Drug Combinations; D015118:Eicosapentaenoic Acid; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D007975:Leukotriene B4 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D012812:Sigmoidoscopy
D004042:Dietary Fats, Unsaturated; D004338:Drug Combinations; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; C045153:Maxepa; D007975:Leukotriene B4; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; D015232:Dinoprostone; D011241:Prednisone