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Updated: May 5, 2026

Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
Published on: May 16, 2025
Lecithin as a therapeutic agent in ulcerative colitis
Wolfgang Stremmel1, Annika Gauss
1Department of Gastroenterology, Internal Medicine IV, University Clinics of Heidelberg, Heidelberg, Germany.
Phosphatidylcholine (PC) in gut mucus forms a barrier against bacteria. Reduced PC in ulcerative colitis (UC) allows bacterial invasion, leading to inflammation. Supplementing PC may be a new UC therapy.
Area of Science:
- Gastroenterology
- Microbiology
- Biochemistry
Background:
- Intestinal mucus layer phospholipids are primarily phosphatidylcholine (PC), forming a hydrophobic barrier.
- PC acts as a surfactant, preventing colonic commensal microbiota invasion.
- Ulcerative colitis (UC) shows a significant reduction (approx. 70%) in mucus PC content, independent of inflammation.
Purpose of the Study:
- To investigate the pathogenetic role of reduced mucus PC in UC.
- To develop and evaluate a novel therapeutic strategy for UC by substituting the deficient mucus PC.
- To assess the efficacy of a delayed-release PC formulation in managing UC.
Main Methods:
- Analysis of phospholipid composition in the intestinal mucus layer.
- Development of a delayed-release phosphatidylcholine (PC) formulation.
- Clinical and endoscopic evaluation of delayed-release PC in randomized controlled studies.
Main Results:
- Reduced mucus PC content in UC patients may facilitate bacterial entry and mucosal inflammation.
- Delayed-release PC formulation effectively compensated for the lack of endogenous PC.
- Clinical and endoscopic improvements were observed in UC patients treated with delayed-release PC.
Conclusions:
- Decreased phosphatidylcholine (PC) in the intestinal mucus is a potential key factor in ulcerative colitis (UC) pathogenesis.
- Delayed-release PC formulation demonstrates therapeutic potential for UC by restoring the mucus barrier.
- Further phase III trials are anticipated for delayed-release PC as an approved UC treatment.
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