Table 2.

Effects of PUFA supplements on gastrointestinal diseases (see footnote to Table 1 for explanations)

Ref.	Disease	Trial characteristics	Outcome measures	Observation summary	Rating and comments
75	CD	RDBP: n–3 FA, 2 trials (n = 363) (n = 375), 58 weeks	Maintenance of remission	No effect on relapse rates	±***** No other medication
74	CD	RDBP: n–3 FA, high risk of relapse (n = 78), 1 year	Relapse rate	59 vs. 26% placebo stayed in remission	++**** Similar dropout rates between groups
73	CD	RDBP: 5-ASA or 5-ASA + n–3 FA, pediatric (n = 38), 1 year	Relapse rate	Lower (61%) relapse with n-3 FA than without (95%)	++**** Relapse delayed with n–3 FA
119	CD	RCP: n–3 FA (n = 70) vs. low-carb diet (n = 65) vs. placebo (n = 69), 1 year; prednisone for 1st 2 months	Remission maintenance, CDAI and CRP	n–3 FA not better than placebo; diet was better as long as maintained	±****
120	CD	RDB: impact powder with/without extra n–3 FA + arginine + RNA + protein (n = 31), 9 weeks	CDAI, leptin levels, BMI	Extract may have marginal benefits for CDAI	+*** Role of n–3 FA not clear
121	CD	RDBP: impact powder + AO or impact powder + AO + n–3 FA or placebo, patients in remission (n = 70), 3 months	Antioxidant levels, FA incorporation	Increase in antioxidant levels with AO treatment; n-3 FA resulted in better FA profile	±*** 33% dropout rate
122	CD	RDB: impact powder with n–3 or n–6 FA (n = 31), active CD into remission (or decreased CDAI), 9 weeks	Clinical and biochemical markers for inflammation	n–3 FA and n–6 FA inhibited proinflammatory cytokines and decreased CDAI	++*** Too many ingredients
123	CD	RDB: impact powder with n–3 or n–6 FA (n = 31), 9 weeks with prednisolone tapering	Insulin-like growth factors	All measured factors increased with both; no difference between groups	+*** Role of PUFA not clear; too many ingredients used
124	CD/UC	RDB: seal oil (n = 20) vs. cod oil (n = 18), 2 weeks	Joint pain	Joint pain improved somewhat with both	+**
125	CD/UC	RP: seal oil (n = 10) vs. soy oil (n = 9), 10 days	Joint pain	Improvement with seal oil but not soy oil	+** Seal oil still better than baseline 6 months later
78	UC	RO crossover: compare n–3 FA from fish oil vs. sulfasalazine (n = 10), 2 months	Blood parameters, CRP, total fecal nitrogen excretion	Sulfasalazine worked better than n–3 FA	±** Small study
126	UC	RDBP: fish oil (n = 9) vs. placebo (n = 9), with standard meds, 6 months	Disease activity, clinical, histology, cytokines	All measured parameters decreased	+** Confirmed in [127, 128]
77	UC	RDBP crossover: sulfasalazine with or without fish oil (n = 9), 2 + 2 months	Antioxidant status in active UC, disease activity	Fish oil improved only the antioxidant status activity	+**** Small study
129	UC	RDBP: supplement with fish oil, selenium, vit. E, vit. C, gum arabic, fructooligosaccharides vs. placebo (n = 121), 6 months	Prednisone use, DAI and histology	Prednisone use decreased	+**** Too many ingredients
130	UC	O: MAX-EPA capsules, patients refractive to other treatment (n = 9), 8 weeks	Safety, tolerability, stool diaries, sigmoidoscopy, symptom response	Marked to moderate improvement in 7 patients, decreased steroid dose in 4	++** Pilot study, well tolerated
76	UC	RDBP crossover: MAX-EPA vs. placebo, active UC, usual meds continued (n = 18), 4 + 4 months, 1 month washout	Flexible sigmoidoscopy, symptom review, rectal biopsy, pEG2, leukotriene B4	Leukotriene B4 decreased, histology improved, weight gain; no changes with placebo	++**** Small study