Postoperative supplementation of propionate and silicon dioxide in patients after total gastrectomy - preliminary report.

INTRODUCTION: Post-operative impairment of gastrointestinal tract function and metabolic consequences occur in patients after gastrectomy by Roux-en-Y method. Short-chain fatty acids and silicon dioxide may prove beneficial in the treatment of these conditions. AIM: To evaluate a preparation containing propionic acid and silicon dioxide on the body weight, number of stools and their consistency (the Bristol scale), and pain and a feeling of gastric fullness after a meal, in patients after gastrectomy by Roux-en-Y method. MATERIAL AND METHODS: Measurements were performed at the beginning of the study, on day 7 and 14 of application (Colostop®; Miralex, 2 × 15 g/day). RESULTS AND CONCLUSIONS: Initially the average daily number of movements was 10/day, after the therapy it was 3.8/day. At the beginning of the study, 3 patients described their faeces as type 6 and two as type 7 on the Bristol scale. After supplementation, 3 patients described stool consistency as type 5, and two as type 4. Initially, patients rated their pain at 3.4/10 on average, the stomach fullness as 4.6/10. At the end of the study, 3 patients did not feel any pain, while others reported pain at 1/10. Four patients described their feeling of gastric fullness as 1/10, and 1 no longer observed this feeling. Patients disclaimed any adverse effects, and satisfaction after therapy reached 9-10/10 points. Patients' body weight did not change significantly. An improvement in standard diet tolerance was observed. Despite the limited study group, clinical benefits of the supplementation were observed.

Determination of butyric acid dosage based on clinical and experimental studies - a literature review.

Short-chain fatty acids produced by bacteria living in the large intestine are the main energy substrate for the colonocytes. Butyric acid is used for the treatment and prevention of exacerbations of various gastrointestinal diseases: diarrhoea, intestinal inflammations, functional disorders, dysbiosis, and post-surgery or post-chemotherapy conditions. The current standard doses of butyric acid (150-300 mg) range between 1.5-3% and 15-30% of the reported daily demand. Increased metabolism of the colonocytes in conditions involving intestine damage or inflammation, increased energy expenditure during a disease, stimulation of intestine growth in 'stress' conditions with accelerated intestinal passage and increased intestinal excretion, and decreased production of endogenous butyrate due to changes in bacterial flora in different pathological conditions require a significant increase of the supply of this acid. Physiological high demand for butyrate and known mechanisms of pathological conditions indicate that current supplementation doses do not cover the demand and their increase should be considered.