[Comparative study of the evolution of inflammatory colitis treated with an elemental diet, glutamine and 5-ASA. An...

The objective of the present investigation was to study the evolution of untreated inflammatory disease of the colon as compared to disease treated with an elemental diet plus glutamine, with 5-ASA and with a combination of the three. A total of 120 female Wistar-Tecpar rats aged 180 days and weighing on average 290 g were studied. Inflammatory disease of the colon was induced with 10% acetic acid and the animals were divided at random into four groups of 30 rats each. Group A, which received a standard diet and no type of treatment, was used as control. Group B received an elemental diet supplemented with glutamine. Group C received a standard diet and daily 5-ASA enemas, 15 mg/ml. Group D received an elemental diet supplemented with glutamine plus daily 5-ASA enemas. Ten animals were picked at random from each group and sacrificed on the 7th, 14th and 21st days of treatment after intravenous injection of Evans blue for visualization of the damaged areas. Changes in weight and the macroscopic aspects of the abdominal cavity and the colon were evaluated and the involved segment was resected for macroscopic and microscopic analysis. The highest weight loss occurred in group D animals on the 14th and 21st days. The number of complications was larger in group A animals, with intestinal perforation, peritonitis and death (P = 0.0053). Complications were of equal intensity in groups B and C and no complications were detected in group D. Macroscopic evaluation showed a lower frequency of ulcers on the 7th day in group B (P = 0.0113) and D (P = 0.0294). Group D animals showed a significantly reduced frequency of ulcers on the 14th day (P = 0.0140). Microscopic examination showed a better evolution in groups B (P = 0.0113) and D (P = 0.0294) on the 7th day and in group D on 14th day (P = 0.0105) compared to A. We conclude that the combination of an elemental diet containing glutamine and treatment with 5-ASA leads to more rapid healing of the colon lesions induced by 10% acetic acid in rats.