Distribution of Mesalamine Enemas in Patients With Active Distal Ulcerative Colitis

NICHOLAS J. CHAPMAN, MANUEL L. BROWN, SIDNEY F. PHILLIPS, WILLIAM J. TREMAINE, KENNETH W. SCHROEDER, MRINAL K. DEWANJEE, ALAN R. ZINSMEISTER

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31 Scopus citations

Abstract

Mesalamine (5-aminosalicylic acid), a topically administered anti-inflammatory agent, is effective treatment by enema for distal ulcerative colitis; it lacks many of the side effects of orally administered sulfasalazine. In this study, we determined the colonic distribution of a 60-ml mesalamine enema in eight patients (five women and three men, 18 to 48 years old) with active distal ulcerative colitis that ranged from 12 to 40 cm proximal to the anal verge. On 3 consecutive days, each patient self-administered a 4-g (60-ml) 5-aminosalicylic acid enema that contained 3.7 MBq of [99mTc]technetium-sulfur colloid. Anterior and posterior images were obtained at 0, 30, 60, 120, and 240 minutes. During the 4-hour study period, all patients retained the enemas. The enemas spread to the sigmoid region in 24 of 24 studies, to the splenic flexure region in 22 of 24, and to the transverse colon in 1 of 24. Most of the enema was retained in the sigmoid colon. Therefore, we conclude that a 60-ml enema, when administered as recommended clinically, routinely flows retrograde as far as the splenic flexure but rarely spreads beyond this point. These results support the use of intrarectally administered 5-aminosalicylic acid for segmental colitis of the descending colon.

Original languageEnglish (US)
Pages (from-to)245-248
Number of pages4
JournalMayo Clinic proceedings
Volume67
Issue number3
DOIs
StatePublished - Jan 1 1992

ASJC Scopus subject areas

  • Medicine(all)

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    CHAPMAN, NICHOLAS. J., BROWN, MANUEL. L., PHILLIPS, SIDNEY. F., TREMAINE, WILLIAM. J., SCHROEDER, KENNETH. W., DEWANJEE, MRINAL. K., & ZINSMEISTER, ALAN. R. (1992). Distribution of Mesalamine Enemas in Patients With Active Distal Ulcerative Colitis. Mayo Clinic proceedings, 67(3), 245-248. https://doi.org/10.1016/S0025-6196(12)60100-1