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Less widely known is that butyrate, at the concentration (c20 mM) typically found in the healthy colonic lumen, is toxic to colon epithelial cells. It is probably the presence of the continuous adherent mucus layer in the healthy colon that ensures that butyrate concentrations in contact with the epithelium fall below the levels (c &gt; 3 mM) that are consistently toxic in\n                    <jats:italic>in vitro<\/jats:italic>\n                    or\n                    <jats:italic>ex vivo<\/jats:italic>\n                    studies. In active ulcerative colitis, the adherent mucus layer is commonly weakened or absent. In this situation, it is likely that the luminal butyrate concentration will be toxic to the epithelium. It follows that butyrate at concentrations typically present in the colon lumen is probably beneficial when colitis is in remission but harmful when colitis has relapsed. This may explain the largely negative results of butyrate therapy in ulcerative colitis and could also account for the recently reported benefit from total enteral nutrition. 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