Short-term duodenal seal oil administration normalised n-6 to n-3 fatty acid ratio in rectal mucosa and ameliorated bodily pain in patients with inflammatory bowel disease

BACKGROUND: A high dietary intake of n-6 compared to n-3 fatty acids (FAs) may promote the production of pro-inflammatory eicosanoids and cytokines. In two recent studies, short-term (10-day) duodenal administration of n-3 polyunsaturated fatty acid rich seal oil ameliorated joint pain in patients with inflammatory bowel disease (IBD). Using unpublished data from these two studies we here investigated whether normalisation of the n-6 to n-3 FA ratio in blood and tissues by seal oil administration was associated with improved health related quality of life (HRQOL) as assessed by the generic short-form 36 (SF-36) questionnaire. RESULTS: In the first pilot study, baseline n-6 to n-3 FA ratio in rectal mucosal biopsies from 10 patients with IBD (9 of those had joint pain) was significantly increased compared with that in 10 control patients without IBD or joint pain. Following seal oil administration, the n-6 to n-3 FA ratio of the IBD-patients was significantly lowered to the level seen in untreated controls. In the subsequent, randomized controlled study (n = 19), seal oil administration reduced the n-6 to n-3 FA ratio in blood similarly and also the SF-36 assessed bodily pain, while n-6 FA rich soy oil administration had no such effect. CONCLUSION: In these two separate studies, short-term duodenal administration of seal oil normalised the n-6 to n-3 FA ratio in rectal mucosa and improved the bodily pain dimension of HRQOL of patients with IBD-related joint pain. The possibility of a causal relationship between n-6 to n-3 FA ratio in rectal mucosa and bodily pain in IBD-patients warrants further investigations

Reduced Joint Pain after Short-term Duodenal Administration of Seal Oil in Patients with Inflammatory Bowel Disease: Comparison with Soy Oil

Background: Rheumatic joint pain is a common extraintestinal complication of inflammatory bowel disease (IBD). Because the high ratio of n-6 to n-3 fatty acids (FAs) of the Western diet might promote rheumatic disorders, we wanted to compare the effects of short-term duodenal administration of n-3 rich seal oil and n-6 rich soy oil, on IBD-related joint pain. Methods: Nineteen patients with IBD-related joint pain were included, 9 had Crohn’s disease and 10 had ulcerative colitis. Ten ml of seal oil (n = 10) or soy oil (n = 9) was self-administered through a nasoduodenal feeding tube 3 times daily for 10 days. Results: Compared with soy oil treatment, seal oil significantly reduced the duration of morning stiffness (P = 0.024), number of tender joints (P = 0.035), intensity of pain (P = 0.025) and the doctor’s scoring of rheumatic disease activity (P = 0.025) at end of the 10 days’ treatment period. Analysing the effects as area under the curve (area between the curve and baseline, zero) for the entire period from start of treatment until 6 months’ post treatment, suggested a long-lasting beneficial effect on joint pain of seal oil administration, while soy oil tended (not significantly) to aggravate the condition. Consistently, the serum ratios of n-6 to n-3 FAs (P << 0.01) and arachidonic acid to eicosapentaenoic acid (P << 0.01) were reduced after treatment with seal oil. Conclusion: The results suggest distinctive differential prolonged effects on IBD-related joint pain of short-term duodenal administration of n-3 rich seal oil (significant improvement) and n-6 rich soy oil (tendency to exacerbation)