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At least 271 records · Page 15Linked to original sources
PubMed1987

5-Aminosalicylic acid enemas in treatment of distal ulcerative colitis and proctitis in Canada.

The efficacy and safety of 4 g 5-aminosalicylic acid (5-ASA) enemas were assessed in 59 patients with ulcerative colitis involving up to 50 cm of their distal colon. Twenty-nine patients received 5-ASA and 30 received a placebo. There were 12 dropouts (five in the active and seven in the placebo group) during the study because of insufficient efficacy. After six weeks of therapy, 63% of the patients receiving the 5-ASA were considered to be "much improved" by the study physician compared to 20% patients on placebo (P less than 0.0001). A disease activity index (DAI), based upon patient symptoms and sigmoidoscopic appearance, was used to assess efficacy. Mean DAI declined 75% for patients on 5-ASA enemas and 32% for patients on placebo (P less than 0.05). The 5-ASA enemas are well tolerated and are of benefit in the treatment of ulcerative colitis confined to the distal colon.

Adult↗
PubMed1985

Parks' coloanal pull-through anastomosis for severe, complicated radiation proctitis.

A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum.

Aged↗
PubMed1984

Proctitis following fecal diversion.

Nonspecific colitis, histologically similar to ulcerative colitis, may be seen in the defunctionalized colon of patients who have undergone fecal diversion for indications other than inflammatory bowel disease. Little is known about this entity, which may have important diagnostic and therapeutic implications in any patient who undergoes fecal diversion. A case of symptomatic diversion colitis is presented. A review of the records of all patients who underwent fecal diversion in our hospital between 1978 and 1983 yielded one additional patient with asymptomatic colitis in the defunctionalized rectum. Further review of the literature produced only two articles pertaining to diversion colitis, underscoring the lack of recognition of this entity in this group of patients.

Aged↗
PubMed2003

Sucralfate versus mesalazine versus hydrocortisone in the prevention of acute radiation proctitis during conformal radiotherapy for prostate carcinoma. A randomized study.

PURPOSE: To assess whether the topical use of steroids or 5-aminosalicylic acid (5-ASA) is superior to sucralfate in preventing acute rectal toxicity during three-dimensional conformal radiotherapy (3DCRT) to 76 Gy. PATIENTS AND METHODS: Patients undergoing 3DCRT for prostate carcinoma at our institution were offered to be randomized to sucralfate 3 g in 15 ml suspension enema (Antepsin, mesalazine 4 g gel enema (Enterasyn, or hydrocortisone 100 mg foam enema (Colifoam. Randomization was blind to the treating physician but not to the patient. Sucralfate was chosen as control arm. Topical treatment had to be performed once daily, starting on day 1 of 3DCRT. Acute rectal toxicity was scored weekly according to RTOG criteria. Time to occurrence of grade 2+ acute rectal toxicity was taken as endpoint. RESULTS: The trial was opened in August 1999, and after the first 24 patients had been treated, arm 2 was discontinued because of eight patients receiving mesalazine, seven actually developed acute rectal toxicity (five patients grade 3 and two patients grade 2). Until May 2001, 134 consecutive patients were randomly assigned to sucralfate (63 patients), mesalazine (eight patients) or hydrocortisone (63 patients). The cumulative incidence of acute rectal toxicity at the end of treatment by arm is 61.9 +/- 6.1%, 87.5 +/- 11.7%, and 52.4 +/- 6.2% for arms 1, 2, and 3, respectively. The difference between the mesalazine group and the sucralfate group is highly significant (hazard ratio [HR] 2.5, 95% confidence interval [CI] 1.1-5.7; p = 0.03). At both uni- and multivariate analysis taking into account several patients and treatment covariates, the difference between hydrocortisone and sucralfate is not significant (HR 0.7, 95% CI 0.5-1.2; p = 0.2). CONCLUSION: Topical mesalazine is contraindicated during radiotherapy. Hydrocortisone enema is not superior to sucralfate in preventing acute rectal toxicity.

Acute Disease↗
PubMed2005

Efficacy of rebamipide enemas in active distal ulcerative colitis and proctitis: a prospective study report.

Rebamipide has a broad spectrum of pharmacological actions that include suppression of neutrophil functions and stimulation of mucosal epithelial cell regeneration by increasing the expression of epithelial growth factor (EGF) and the EGF receptor. Sixteen patients with active ulcerative colitis (UC; mild in 1 patient, moderate in 11, and severe in 4) were recruited. Enemas containing 150 mg rebamipide per dosing were administered during the daytime after passage of stool, twice a day for 4 weeks. UC disease activity index (UC-DAI), endoscopic activity index (EAI), and Floren's grading (FG) of mucosal biopsy specimens were measured at entry and at 4 weeks. Five of 16 patients did not complete the study, and therefore, final efficacy assessment was done on 11 patients who completed the 4 weeks of treatment. Improvements were observed in UC-DAI (P = 0.0049), EAI (P = 0.0043), and FG (P = 0.0084). There was no serious rebamipide-related side effect in any of the 16 patients. In conclusion, rebamipide topical therapy appears to be effective for the treatment of mildly to moderately active distal UC. Further controlled studies are warranted for this promising drug.

Adolescent↗