Problematic proctitis and distal colitis

  title={Problematic proctitis and distal colitis},
  author={Paolo Gionchetti and Fernando Rizzello and Claudia Morselli and Massimo Campieri},
  journal={Alimentary Pharmacology \& Therapeutics},
About two‐thirds of patients with ulcerative colitis have an inflammatory involvement distal to the splenic flexure, and therefore may be effectively treated with topical treatment, allowing the delivery of the active drug directly to the site of inflammation and limiting systemic absorption and potential side‐effects. Topical aminosalicylate therapy is the most effective approach, and most patients will benefit hugely, provided that the formulation reaches the upper extent of the disease… 
Ulcerative proctitis: a review of pharmacotherapy and management
Topical medication with rectally administered 5-aminosalicylic acid (5-ASA)/corticosteroid suppositories or enemas is effective treatment for most ulcerative proctitis patients, although oral 5- ASA as maintenance therapy might prevent proximal extension of the disease.
Therapeutic strategies for the management of ulcerative colitis
The evidence supporting new patterns of use of existing therapies and new therapies are highlighted, and therapeutic pathways that incorporate these new treatments are proposed to improve the outcome in patients with mild‐to‐moderately active UC, chronicactive UC, resistant proctitis, and fulminant UC.
European evidence-based Consensus on the management of ulcerative colitis: Current management.
The simplest, best validated and most widely used index for identifying acute severe UC remains that of Truelove & Wi_tts 3: any patient who has a bloody stool frequency ≥ 6/day and a tachycardia and temperature > 37.8 °C, or anaemia has severe ulcerative colitis.
Colonoscopic evaluation in ulcerative colitis
  • E. Paine
  • Medicine
    Gastroenterology report
  • 2014
The extent and behavior of UC has been characterized further using various indices and scoring systems; among these systems is the Mayo Score, which is widely used in current clinical trials for new medications.
Pathogenesis, Diagnosis, and Management of Ulcerative Proctitis, Chronic Radiation Proctopathy, and Diversion Proctitis
An overview of the latest data on the clinical features, etiologies, diagnosis, and management of ulcerativeProctitis, chronic radiation proctopathy, and diversion proctitis is provided.
New targeting strategies in drug therapy of inflammatory bowel disease: mechanistic approaches and opportunities
The article offers an updated overview of recently developed delivery systems aimed to achieve maximal drug concentrations in the inflamed intestinal tissues with minimal systemic side effects.
European evidence-based Consensus on the diagnosis and management of ulcerative colitis: Definitions and diagnosis.
The aim of the Consensus is to promote a European perspective on the management of ulcerative colitis (UC) and its dilemmas and to avoid duplication of effort in the future.
Review article: the role of non‐biological drugs in refractory inflammatory bowel disease
A small number of patients with inflammatory bowel disease do not respond to, or are intolerant of conventional immunosuppressive drugs, and biological agents are alternative treatments, which may not be suitable or available to some patients.
Preparation and Characterization of Nicotine/Ca-alginate Composite Microcapsules for the Enteric Controlled Drug Release
The aim of the present study was to develop drug-loaded microcapsules to increase drug bioavailability at target site especially for colon-targeted oral delivery. Nicotine was selected as a model


Budesonide versus prednisolone retention enemas in active distal ulcerative colitis
Clinical remission was achieved in 16% of the patients in the budesonide group after four weeks and in 24% in the prednisolone group and there were no statistically significant differences between the two groups.
Treatment of refractory distal ulcerative colitis with short chain fatty acid enemas.
This open-labeled study in patients with highly refractory distal UC confirms other studies as to the efficacy of this treatment and further confirms the need for controlled trials of this promising therapy.
Epidermal growth factor enemas with oral mesalamine for mild-to-moderate left-sided ulcerative colitis or proctitis.
Preliminary data suggest that EGF enemas are an effective treatment for active left-sided ulcerative colitis, and this benefit was maintained at 4 weeks and at 12 weeks.
Comparison of oral with rectal mesalazine in the treatment of ulcerative proctitis
Results of this study indicate that treatment with mesalazine suppositories produces earlier and significantly better results than oral Mesalazine in the treatment of active ulcerative proctitis.
Topical treatment of ulcerative proctitis with lidocaine.
Findings indicate that hyperactive local nervous reflexes are of pathogenetic importance and topical treatment with lidocaine gel in 21 consecutive patients with UP/PS for 3-8 weeks caused a rapid decrease of subjective and objective symptoms.
Retrograde colonic spread of a new mesalazine rectal enema in patients with distal ulcerative colitis
The purpose of the present study was to assess by scintigraphy the colonic distribution of this new mesalazine rectal gel enema preparation using a device which excludes direct contact of the inert propellant gas with the active drug.
A controlled trial of azathioprine in the management of chronic ulcerative colitis.
Although azathioprine does not confer dramatic benefit upon patients with chronic ulcerative colitis who require steroids, it does permit reduction of steroid dosage without apparent worsening of the disease.
5-Aminosalicylic acid as enemas or suppositories in distal ulcerative colitis?
It was the patients' opinion that treatment with suppositories was easier than that with enemas (p less than 0.01), and no difference could be observed in terms of efficacy.
Distribution of mesalazine enemas in active and quiescent ulcerative colitis.
Volume, but not disease activity, is the important determinant of retrograde colonic spread of mesalazine enemas in ulcerative colitis.
A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis.
The combination of oral and rectal mesalamine therapy was well tolerated and produced earlier and more complete relief of rectal bleeding than oral or rectal therapy alone.