Coconut water more effective than placebo for inducing clinical remission in patients with mild to moderate ulcerative colitis: Study

Coconut water is more effective than a placebo for inducing clinical remission in patients with mild to moderate ulcerative colitis suggests a study published in the Clinical Gastroenterology and Hepatology.

Coconut water more effective than placebo for inducing clinical remission in patients with mild to moderate ulcerative colitis: Study

Coconut water (CW) is anti-inflammatory, can manipulate the gut microbiome, and is a rich source of potassium. Gut microbiome modulation improves outcomes in ulcerative colitis (UC), and potassium possesses in vitro anti-inflammatory properties. They evaluated the effect of CW as an adjunct therapy for patients with mild-moderate UC. This single-centre, double-blind, placebo-controlled trial randomised patients with mild to moderate (Simple Clinical Colitis Activity Index [SCCAI]: 3–9) endoscopically active UC (Ulcerative Colitis Endoscopic Index of Severity [UCEIS] >1) in 1:1 ratio to CW + standard medical therapy (SMT) vs placebo + SMT. Four hundred mL of CW was administered for 8 weeks. The primary outcome measure was clinical remission (SCCAI ≤2), and the secondary outcome measures were clinical response (SCCAI decline ≥3) and adverse events at 8 weeks.

Microbiome was analyzed at baseline and 8 weeks. Results: Of 121 patients screened, 95 were included for modified intention to treat analysis (CW, n = 49; placebo, n = 46) (mean age, 37.2 ± 11.2 years; males, 54.1%; disease duration, 48 months [interquartile range (IQR), 24–90 months]; pancolitis, 26.1%; SCCAI, 5 [IQR, 4–6]; UCEIS, 4 [IQR, 3–5]). Clinical response (57.1% vs 28.3%; odds ratio [OR], 3.4; 95% confidence interval [CI], 1.4–7.9; P = .01), remission (53.1% vs 28.3%; OR, 2.9; 95% CI, 1.2–6.7; P = .02), and proportion of patients with fecal calprotectin (FCP) <150 μg/g (30.6% vs 6.5%; OR, 6.3; 95% CI, 1.7–23.6; P = .003) were significantly higher in CW. The relative abundance of bacterial taxa that had a significant or trend towards negative correlation with SCCAI, UCEIS, or FCP increased at 8 weeks in CW, and this effect was independent of disease activity and dietary fiber. Adverse events were comparable, and no patient developed hyperkalemia. CW was more effective than placebo for induction of clinical remission in patients with mild to moderate UC.