Short chain fatty acid enemas

Patient information leaflet for the use of short chain fatty acid enemas in the management of diversion colitis.

Drug name/brand

Short chain fatty acid (SCFA) enemas are not currently licensed in the UK, meaning they are not approved for this indication in the UK. Although the manufacturer may vary, the information within this leaflet relates to the product manufactured by Prulab Phamaa (Prulab brand) and St Marys Pharmaceutical Unit (unbranded, just states fatty acid enema).

Supply

This will be supplied by the outpatient pharmacy at Cambridge University Hospitals NHS Foundation Trust. You will be given enough for the first month of treatment then, if your symptoms are improving and treatment is to be continued, further supplies will be organised.

The supply of any equipment you require in order to administer this medication will be arranged by the inflammatory bowel disease (IBD) specialist nurses.

Formulation

A sterile (preservative-free), clear and colourless mixture of three short chain fatty acids (sodium acetate trihydrate, sodium propionate and sodium butyrate).

Storage

The shelf life may vary depending on the manufacturer that it has been bought from, therefore always look at the expiry date on the bottle (usually it is one year from manufacturer). It is recommended to not use the product after it has been open for 28 days.

The product must be kept in its original packaging.

The product must be stored between 15°C and 25°C – before and after opening.

Dose

Your dose will be adjusted according to your response to treatment and will be prescribed by the specialist doctor.

• The starting dose is usually 10ml into the rectum twice a day for one month.
• If improvement is seen, this may be reduced to 10mL once daily.
• Over time, this dose may change. Any decisions about this will be made by your specialist doctor.

Administration

For rectal use only

Start by washing your hands and clearing a clean surface in your bedroom or bathroom to work on. Please note that SCFA enemas have a malodour and therefore should be handled carefully.

Ensure the syringes used are compatible before use.

1. Use a suitable size of Luer tip syringe to draw up the required dose of SCFA, ie a 10ml or 20ml syringe.
2. Transfer the contents of the syringe into a 50ml catheter syringe by inserting the syringe's tip into the catheter tip and pushing in the contents.
3. Lubricate the catheter tip syringe with a lubricant such as Optilube.
4. Administer rectally while lying down on your side. Try to hold the solution inside for as long as possible before using the toilet – at least 30 minutes is ideal.
5. Dispose of the Luer syringe in a normal bin after a single use.
6. Rinse and clean the 50ml catheter tip syringe after each use, and dispose of it after seven days.

Further information

This leaflet is only a guide. Further information may be obtained from your hospital doctor or IBD specialist nurse.

If you have side effects or problems with your medication you can contact the IBD specialist nurses on 01223 257212.

Contacts

Inflammatory Bowel Disease Helpline (voicemail): 01223 257212
Pharmacy Medicines Information Helpline: 01223 217502 – Monday to Friday 09:00 (9am) to 17:00 (5pm).