Related Experiment Video
Updated: Jan 7, 2026
Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
Published on: November 27, 2016
Fecal butyric acid as a predictive biomarker of endoscopic remission in inflammatory bowel disease: a multicenter
Katarzyna Karłowicz1, Konrad Lewandowski1, Danuta Domżał-Magrowska2
1Department of Gastroenterology and Internal Medicine, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.
Introduction:
Effective prediction of endoscopic remission is a key to optimizing ulcerative colitis (UC) management. While fecal calprotectin (FC) is widely used, its limitations highlight the need for complementary biomarkers. This study evaluated fecal butyric acid (C4) as a novel, non-invasive predictor of endoscopic remission in UC.
Aim:
To assess the association between fecal C4 levels and endoscopic remission (Mayo score 0), and secondarily/also, the correlation between C4 and FC.
Material And Methods:
A multicenter, prospective study enrolled 100 UC patients between April 2021 and April 2023, including 26 in remission and 74 with active disease. Inclusion criteria were confirmed UC diagnosis for ≥ 1 year and stable therapy without medication changes. Fecal C4 was measured using mass spectrometry. Analyses included descriptive statistics, group comparisons, receiver operating characteristic (ROC) curve analysis, and Spearman correlation.
Results:
Patients in remission had significantly higher fecal C4 levels (mean difference: 4.05 nM/mg; 95% CI: 2.44-5.71; p < 0.001) and lower Mayo scores. C4 showed excellent predictive performance (area under the curve (AUC) = 0.943; 95% CI: 0.897-0.980; p < 0.001), with 100% sensitivity and 86% specificity at a cutoff of 1.68 nM/mg. No significant correlation was found between C4 and FC.
Conclusions:
Fecal C4 is a promising biomarker for predicting endoscopic remission in UC, offering high sensitivity and specificity. Its use may enhance clinical decision-making and support individualized treatment approaches. Further validation in larger cohorts is warranted to confirm these findings and establish its clinical utility.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:29Drugs for Treatment of Ulcerative Colitis in IBD