Abstract
There are few published guidelines for the treatment of inflammatory bowel disease. Physicians choose therapy based on evidence-based data, peer and expert opinion, and personal experience. This article provides treatment guidelines for the induction and maintenance of ulcerative proctitis and left-sided colitis and the management of disease refractory to 5-aminosalicylic acid (5-ASA) compounds and corticosteroids The guidelines are derived from evidence-based data and, when lacking, expert opinion or the authors' experience. The comprehensive review of the literature is presented in the accompanying article, "The Medical Management of Left-Sided Ulcerative Colitis and Ulcerative Proctitis: Critical Evaluation of Therapeutic Trials". Rectally administered 5-ASA and corticosteroid suppositories are effective treatment for most ulcerative proctitis patients. Corticosteroid and 5-ASA enemas, which reach the splenic flexure of the colon, are recommended for patients with left-sided ulcerative colitis. The combination of rectally administered 5-ASA enemas and oral 5-ASA agents may afford better treatment of left-sided colitis and possibly prevent proximal extension of disease. Patients refractory to 5-ASAs and corticosteroids may require an immunomodulator or biological response modifier therapy. Those who have ongoing signs and symptoms of ulcerative proctitis and left-sided ulcerative colitis despite maximal medical therapy require a proctocolectomy.
Original language | English (US) |
---|---|
Pages (from-to) | 972-978 |
Number of pages | 7 |
Journal | Inflammatory bowel diseases |
Volume | 12 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2006 |
Keywords
- 5-aminosalicylates
- Corticosteriods
- Immunomodulators
- Infliximab
- Left-sided ulcerative colitis
- Medical management
- Medical treatment
- Ulcerative colitis
- Ulcerative proctitis
ASJC Scopus subject areas
- Immunology and Allergy
- Gastroenterology