Hydrocortisone stability in human feces.

Area of Science:

• Pharmacology
• Gastroenterology
• Microbiology

Background:

• Hydrocortisone enemas show variable efficacy in ulcerative colitis treatment.
• The stability of hydrocortisone in the colonic environment is not well understood.

Purpose of the Study:

• To investigate hydrocortisone stability in human feces under different conditions.
• To determine if fecal degradation influences hydrocortisone enema effectiveness.

Main Methods:

• Hydrocortisone stability was assessed in fresh human feces at 37°C and 10°C.
• Assay specificity was confirmed using dual isotopes, TLC, and liquid scintillation counting.
• Degradation was compared to hydrocortisone in water at 37°C.

Main Results:

• Hydrocortisone showed 7-26% degradation in feces at 37°C within 24 hours.
• Degradation was less than 7% in feces stored at 10°C.
• Negligible degradation occurred in hydrocortisone dissolved in water at 37°C, implicating fecal bacteria.

Conclusions:

• Hydrocortisone exhibits significant degradation in human feces at body temperature, likely mediated by fecal bacteria.
• The stability of hydrocortisone in feces may contribute to its local persistence.
• This stability could partly explain the therapeutic efficacy of hydrocortisone enemas for ulcerative colitis.