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Updated: May 30, 2026

Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
Published on: May 16, 2025
Update on the management of ulcerative colitis
Frank Hoentjen1, Atsushi Sakuraba, Stephen Hanauer
1Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, The University of Chicago, 5841 S. Maryland Ave. MC 4076, Chicago, IL 60637, USA.
New biological therapies offer expanded treatment options for ulcerative colitis (UC). Current research highlights effective use of mesalamine, anti-tumor necrosis factor (TNF) agents, and immunosuppressives for managing UC, reducing colectomy rates and hospitalizations.
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Ulcerative colitis (UC) treatment has evolved with the advent of biological therapies.
- Understanding the impact of recent clinical trials is crucial for optimizing UC management.
Purpose of the Study:
- To review controlled clinical trials impacting the management of ulcerative colitis (UC).
- To discuss the efficacy of various therapeutic agents in different UC severity levels.
Main Methods:
- Systematic search of recently published controlled clinical trials on ulcerative colitis.
- Review and synthesis of data on mesalamine, anti-tumor necrosis factor (TNF) agents, and immunosuppressives.
Main Results:
- Mesalamine remains a first-line treatment for mild to moderate UC; once-daily formulations show comparable efficacy and improved compliance.
- For moderate to severe UC, infliximab and adalimumab (anti-TNF agents) are effective in inducing and maintaining remission, reducing colectomy rates and hospitalizations.
- Immunosuppressives like azathioprine and mercaptopurine are associated with decreased colectomy rates; thioguanine is effective for maintenance in intolerant patients. Infliximab and tacrolimus are alternatives for severe, steroid-resistant UC.
Conclusions:
- Long-term maintenance therapy with immunosuppressives or anti-TNF agents is essential for sustained benefit after rescue therapy.
- Further research is needed to establish optimal positioning of anti-TNF agents and combination immunosuppressive therapy for achieving steroid-free remission in UC.
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