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Ulcerative proctitis: an update on the pharmacotherapy and management
Krisztina B Gecse1, Peter L Lakatos
1Semmelweis University, 1st Department of Medicine , Korányi Sándor utca 2a, H1083 Budapest , Hungary +36 20 9117727 ; +36 1 3130250 ; lakatos.peter_laszlo@med.semmelweis-univ.hu.
Expert Opinion on Pharmacotherapy
|May 20, 2014
Summary
Topical 5-aminosalicylates (5-ASA) and corticosteroids effectively treat ulcerative proctitis, with topical 5-ASA showing superior efficacy. Long-term 5-ASA maintenance is crucial for preventing ulcerative colitis relapse and progression.
Area of Science:
- Gastroenterology
- Colorectal Diseases
- Inflammatory Bowel Disease
Background:
- Ulcerative colitis (UC) affects approximately 25% of patients as proctitis.
- Proctitis can progress to left-sided or extensive colitis in up to 50% of cases over time.
Purpose of the Study:
- To summarize and critically review current data on ulcerative proctitis treatment.
- To provide expert opinion on optimal management strategies for ulcerative proctitis and ulcerative colitis.
Main Methods:
- Comprehensive literature search of MEDLINE database up to March 2014.
- Critical review and synthesis of available data on ulcerative proctitis.
Main Results:
- Topical 5-aminosalicylates (5-ASA) and corticosteroids are effective for proctitis but underused.
- Topical 5-ASA is more effective than oral formulations.
- Combination therapy and escalation strategies are recommended for treatment-resistant cases.
Conclusions:
- Short-term UC treatment aims for remission; long-term goals include remission maintenance and preventing progression.
- 5-ASA maintenance therapy is indicated for all UC patients to prevent relapse.
- Refractory cases require re-evaluation; advanced therapies or surgery may be necessary for severe or steroid-dependent disease.
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