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Abstract: Introduction: Short-chain fatty acids affect enterocyte metabolism and differentiation. Butyric acid in particular is already used in ulcerative rectal colitis, pouchitis and antibiotic-induced diarrhoea. Aims: To assess the efficacy of butyrate in the treatment of irritable bowel syndrome (IBS). Patients: Fifty patients with IBS were treated using enteric-coated sodium butyrate tablets at a dosage of 1 g/day for 30 days. Methods: The patients were divided into two subgroups: constipation-predominant IBS and diarrhoea-predominant IBS. The IBS variant and symptom scores of patients were recorded before and after treatment. Results: Treatment with butyric acid reduced in normalisation of status in 68% and 71% of patients in the diarrhoea-predominant IBS group vs. 14% and 16% of patients in the constipation-predominant IBS group (respectively for the intent-to-treat and per-protocol analyses) (p < 0.005). The symptoms score for abdominal pain, meteorism and flatulence was significantly improved in patients with the diarrhoea variant compared with those with the constipation variant (p < 0.05). Conclusions: Oral administration of butyrate may be effective in regulating status and improving gastrointestinal symptoms in patients with the diarrhoea-predominant irritable bowel syndrome. [Copyright &y& Elsevier]