Acetic acid-induced colitis results in bystander ileal injury

The extent of the small intestinal injury following experimental acetic acid induction of colitis in rats was examined. Following intraluminal colonic administration of radiolabelled acetic acid, high levels of radioactivity were identified in the colon and in the liver, while low background levels were found in jejunum, ileum, caecum, and heart. The increased level of radioactivity in the liver relative to that of the heart suggests that a significant portion of the colonic intraluminal acetic acid was absorbed directly into the portal circulation. The colon, which was the only segment of intestine in direct contact with the acetic acid, had the highest levels of radiolabelled acetic acid, demonstrated a marked macroscopic mucosal ulceration, an enhanced myeloperoxidase activity, and a fall in in vivo fluid absorption. The jejunum, which demonstrated low levels of radiolabelled acetic acid was normal without evidence of injury. In contrast, the ileum, which displayed the same levels of radiolabelled acetic acid as did the jejunum, also demonstrated a significant fall in in vivo fluid absorption but showed no mucosal ulceration or increased myeloperoxidase activity. These studies have shown that acetic acid induction of colitis produces evidence of ileal injury but that this injury is not the result of inadvertent delivery of acetic acid or recruitment of neutrophils to the ileal mucosa.