El-Salhy M, Shin CM, Kim YS, Hatlebakk JG. Possible roles of short-chain fatty acids in the pathophysiology and treatment of irritable bowel syndrome. World J Transl Med 2026; 12(3): 122740 [DOI: 10.5528/wjtm.122740]
Corresponding Author of This Article
Magdy El-Salhy, Chief Physician, Professor Emeritus, Department of Medicine, University of Bergen, Haukeland University Hospital, Bergen 5009, Norway. magdy.el-salhy@helse-bergen.no
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Gastroenterology & Hepatology
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review-article
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El-Salhy M, Shin CM, Kim YS, Hatlebakk JG. Possible roles of short-chain fatty acids in the pathophysiology and treatment of irritable bowel syndrome. World J Transl Med 2026; 12(3): 122740 [DOI: 10.5528/wjtm.122740]
World J Transl Med. Sep 28, 2026; 12(3): 122740 Published online Sep 28, 2026. doi: 10.5528/wjtm.122740
Possible roles of short-chain fatty acids in the pathophysiology and treatment of irritable bowel syndrome
Magdy El-Salhy, Cheol Min Shin, Yong Sung Kim, Jan Gunnar Hatlebakk
Magdy El-Salhy, Jan Gunnar Hatlebakk, Department of Medicine, University of Bergen, Haukeland University Hospital, Bergen 5009, Norway
Cheol Min Shin, Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, South Korea
Yong Sung Kim, Kim's GutEase Internal Medicine, Gunpo 15865, South Korea
Yong Sung Kim, Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan 54538, South Korea
Author contributions: El-Salhy M wrote the first draft of the manuscript; Shin CM, Kim YS, and Hatlebakk JG contributed to the data analyses and interpretation, and critically revised the manuscript for important intellectual content.
AI contribution statement: The article did not utilize any AI collaborative tools.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Magdy El-Salhy, Chief Physician, Professor Emeritus, Department of Medicine, University of Bergen, Haukeland University Hospital, Bergen 5009, Norway. magdy.el-salhy@helse-bergen.no
Received: April 27, 2026 Revised: June 16, 2026 Accepted: August 10, 2026 Published online: September 28, 2026 Processing time: 130 Days and 10.2 Hours
Abstract
Short-chain fatty acids (SCFAs) are metabolic products of bacterial fermentation of undigested/unabsorbed carbohydrates and fibers in the intestine. SCFAs are used by intestinal epithelial cells as an energy source and regulates several large-intestine functions, such as motility, visceral sensitivity, the immune system, and the gut barrier. About 95% of SCFAs are acetic, propionic, and butyric acids occurring in proportions of 60%: 20%: 20% in healthy subjects, while the proportion of butyric acid is lower than 20% in irritable bowel syndrome (IBS) patients. Acetic and propionic acids are not correlated with IBS symptoms, suggesting that they are not involved in symptom manifestation. The butyric acid level increased in IBS patients after fecal microbiota transplantation, and was inversely correlated with abdominal pain, diarrhea, and constipation. The effects of butyric acid on IBS symptoms such as abdominal pain, diarrhea, and constipation can be attributed to its modulation of the expression levels of serotonin, peptide YY, and glucagon-like peptide-1 in the intestinal enterochromaffin cells and L-cells. The butyric acid level was also inversely correlated with chronic fatigue, which occurs in about 54% of IBS patients. Treatment with sodium butyrate in capsule form is a promising therapeutic approach for IBS.
Core Tip: Butyric acid appears to play a significant role in irritable bowel syndrome (IBS) symptom manifestation and the overlapping chronic fatigue. Sodium butyrate in capsule form seems to be a promising treatment for IBS.
