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Rectal bismuth subsalicylate as therapy for ulcerative colitis
S D Ryder1, R J Walker, H Jones
1University Department of Medicine, Walton Hospital, Liverpool, UK.
Alimentary Pharmacology & Therapeutics
|August 1, 1990
Summary
Enemas containing bismuth subsalicylate showed significant clinical response and remission in ulcerative colitis patients unresponsive to standard treatments. Further controlled trials are recommended for this promising therapy.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Conventional therapies for UC are not always effective, necessitating alternative treatments.
Purpose of the Study:
- To evaluate the efficacy of rectal bismuth subsalicylate enemas in patients with ulcerative colitis refractory to conventional therapy.
Main Methods:
- A prospective open study involving 15 UC patients.
- Treatment involved rectal enemas of bismuth subsalicylate (700 or 800 mg twice daily).
- Clinical response, sigmoidoscopic findings, and oral prednisolone dosage were assessed over 8 weeks.
Main Results:
- Nine out of 15 patients (60%) showed significant clinical response.
- Six patients (40%) achieved complete clinical remission after 8 weeks.
- Sigmoidoscopic improvement was observed in 11 patients (73%) by week 8, with 6 (40%) showing normal mucosa.
- Median oral prednisolone dosage decreased from 15 mg/day to 6 mg/day, with 5 patients discontinuing steroids.
Conclusions:
- Rectal bismuth subsalicylate appears to be an effective therapeutic option for ulcerative colitis.
- Controlled trials are warranted to confirm these findings and establish optimal treatment protocols.