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

• Published in: Gut 1992-07, Vol.33 (7), p.922-928
• Main Authors: Hawthorne, A B, Daneshmend, T K, Hawkey, C J, Belluzzi, A, Everitt, S J, Holmes, G K, Malkinson, C, Shaheen, M Z, Willars, J E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aminosalicylic Acids - therapeutic use; Biological and medical sciences; Colitis, Ulcerative - drug therapy; Drug Therapy, Combination; Eicosapentaenoic Acid - analogs & derivatives; Eicosapentaenoic Acid - biosynthesis; Eicosapentaenoic Acid - therapeutic use; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Leukotriene B4 - biosynthesis; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Mesalamine; Middle Aged; Olive Oil; Other diseases. Semiology; Plant Oils - therapeutic use; Prednisolone - therapeutic use; Prospective Studies; Remission Induction; Sulfasalazine - therapeutic use
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.33.7.922

The effect of fish oil on the course of ulcerative colitis was investigated in a randomised blinded controlled 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.