Related Experiment Video
Updated: Jun 1, 2026
08:58
Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
Published on: January 5, 2017
Novel topical therapies for distal colitis
1Ian Craig Lawrance, Centre for Inflammatory Bowel Diseases, Department of Gastroenterology, Fremantle Hospital, Fremantle, 6059, WA, Australia; University Department of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, 6059, WA, Australia.
Summary
Resistant distal colitis (DC) requires new topical treatments. This review highlights promising agents like butyrate and tacrolimus, urging further clinical trials for better patient outcomes.
Area of Science:
- Gastroenterology
- Inflammatory Bowel Disease Research
- Pharmacology
Background:
- Distal colitis (DC) is often managed with topical 5-aminosalicylic acid (5ASA) agents, suppositories for rectal delivery and enemas for reaching the splenic flexure.
- Combination therapy with oral 5ASAs enhances inflammation control, but some cases of DC become resistant to standard treatments.
- Resistant DC necessitates systemic therapies like steroids, immunosuppressants, and anti-TNFα agents, which carry risks of side effects and variable efficacy.
Purpose of the Study:
- To review and highlight potentially effective novel topical therapeutic agents for managing resistant distal colitis.
- To stimulate further investigation into these agents, addressing the limitations of current treatment options.
- To emphasize the need for rigorous clinical trials to validate new therapies for resistant DC.
Main Methods:
- Literature review of proposed topical agents for resistant distal colitis.
- Analysis of existing data on agents including butyrate, cyclosporine, nicotine, tacrolimus, ecabet sodium, arsenic, lidocaine, rebamipide, and Ridogrel(®).
- Emphasis on the need for randomized, double-blinded, placebo-controlled trials for validation.
Main Results:
- Several agents, including butyrate, cyclosporine, nicotine, and tacrolimus, have shown promise in preliminary studies for resistant DC.
- Current evidence for most proposed agents is based on small, open-label studies, limiting definitive conclusions.
- Topical agents are attractive due to lower systemic drug levels and infrequent side effects compared to systemic treatments.
Conclusions:
- New topical therapies are needed for resistant distal colitis to mitigate systemic side effects.
- Agents like butyrate, cyclosporine, and tacrolimus warrant further investigation in well-designed clinical trials.
- Rigorous, placebo-controlled studies are essential to establish the efficacy and safety of novel agents for resistant DC.
Related Concept Videos
01:29Drugs for Treatment of Ulcerative Colitis in IBD
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation.
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:21Inflammatory Bowel Disease V: Surgical Management
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD: