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Nicotine enemas for active ulcerative colitis--a pilot study

J T Green1, G A Thomas, J Rhodes

  • 1Department of Gastroenterology, University Hospital of Wales, Cardiff, UK.

Alimentary Pharmacology & Therapeutics
|November 14, 1997
PubMed
Summary
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Topical nicotine enemas show promise for treating active ulcerative colitis, offering an alternative to transdermal nicotine with fewer side effects. Further controlled studies are recommended to confirm efficacy in ulcerative colitis management.

Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Transdermal nicotine is effective for ulcerative colitis but has side effects.
  • Topical nicotine enemas offer a potential alternative therapy.

Purpose of the Study:

  • To evaluate the efficacy and safety of nicotine enemas in treating active ulcerative colitis.

Main Methods:

  • An open study involving 22 non-smoking patients with active colitis.
  • Patients received a 6 mg nicotine enema nightly for 4 weeks.
  • Symptoms, stool frequency, sigmoidoscopy, and rectal biopsies were assessed.

Main Results:

  • 17 of 22 patients completed treatment, with 16 showing improved St. Mark's scores.
  • 12 patients experienced improved urgency and stool frequency; 10 showed improved endoscopic and histological scores.

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  • Three patients achieved full remission, and two more achieved remission after a second month of treatment.

    • Conclusions:

    • Nicotine enemas appear effective as an adjunct to conventional therapy for ulcerative colitis with minimal side effects.
    • Topical nicotine therapy may be a future option for ulcerative colitis management.
    • Controlled studies are necessary to validate these findings.