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At least 163 records · Page 9Linked to original sources
PubMed1992

A steroid enema, budesonide, lacking systemic effects for the treatment of distal ulcerative colitis or proctitis.

The aim of this study was to evaluate whether budesonide enema (2 mg/100 ml) had a significantly better effect than placebo in the treatment of distal ulcerative colitis or proctitis. The trial was of controlled, randomized, double-blind design and included 41 treated patients. The treatment time was 4 weeks, with revisits after 2 and 4 weeks. If no improvement was seen, the patient could be switched over to open-label therapy with budesonide enema. Sigmoidoscopy, histology, blood chemistry, and diary cards were used for estimating the effect of treatment. The results showed that budesonide was superior to placebo. Sigmoidoscopy and biopsy scores improved significantly (p less than 0.01) in budesonide-treated patients compared with placebo. Significantly more patients switched over to open budesonide treatment in the placebo group owing to lack of efficacy compared with budesonide (p less than 0.001). No drug-related adverse experiences occurred, and there was no decrease in endogenous morning plasma cortisol levels. It is concluded that budesonide enema appears to be an effective and safe treatment for distal ulcerative colitis and proctitis.

Administration, Topical↗
PubMed2006

Histopathological comparison of topical therapy modalities for acute radiation proctitis in an experimental rat model.

AIM: To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS: A total of 120 rats were used. Four groups (n = 30) were analyzed with one group for each of the following applied therapy modalities: control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS: The histopathologic scores for surface epithelium, glands (crypts) and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION: Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.

Administration, Topical↗
PubMed2000

Metronidazole in the treatment of chronic radiation proctitis: clinical trial.

AIM: To evaluate the effectiveness of metronidazole in combination with corticosteroids in enema and mesalazine (5-aminosalicylic acid) in comparison with the same protocol without metronidazole in the treatment of chronic radiation proctitis. METHODS: Sixty patients with rectal bleeding and diarrhea were randomly divided into two groups. Patients in the first group were treated with metronidazole (3x400 mg orally per day), mesalazine (3x1 g orally per day), and betamethasone enema (once a day during 4 weeks). Patients in the second group were treated with mesalazine and betamethasone enema, but without metronidazole. The efficacy of metronidazole was assessed on the basis of rectal bleeding, diarrhea, and rectosigmoidoscopy findings in all patients. RESULTS: The incidence of rectal bleeding and mucosal ulcers was significantly lower in the metronidazole group, 4 weeks (p=0.009), 3 months (p=0.031), and 12 months (p=0.029) after therapy. There was also a significant decrease in diarrhea and edema in the metronidazole group, 4 weeks (p=0.044), 3 months (p=0.045), and 12 months (p=0.034) after treatment. CONCLUSION: Metronidazole in combination with mesalazine and betamethasone enemas successfully treats rectal bleeding and diarrhea in chronic radiation proctitis.

Aged↗
PubMed2003

[Long term results of treatment of hemorrhagic radiation proctitis by argon plasma coagulation].

AIM: To assess long term results of argon plasma coagulation (APC) treatment in hemorrhagic radiation proctitis. METHODS: Thirty patients treated with APC in 2 departments were enrolled. In 16 patients, APC was the first treatment used. A clinical scale (Chutkan) was used to assess bleeding before and after treatment. An endoscopic scale was used to assess results on mucosa appearance. RESULTS: The mean course number was 2.3 (extremes 1-5). Bleeding score decreased from 2.67 to 0.77 (P<0.001). The success rate was 26/30 patients (87%) in an intention-to-treat analysis with 2 failures (6%), 1 patient lost for follow up and 1 patient not referred after one session. Improvement in endoscopic appearance was observed in the 13 endoscopically controlled patients with a decrease of the endoscopic score from 1.61 to 0.3 (P<0.002). The overall morbidity was 47% with 3 severe complications (10%): 1 severe bleeding, 1 extensive necrosis of lower part of the rectum and 1 perforation. We also noticed 3 microrecties and 2 symptomless rectal stenosis. With regard to tolerance, we observed post treatment pain in 6 patients (20%), easily released by usual antalgics. Complications and side effects occurred, in all patients but one, when power shot was > 45 W. Mean follow up was 20 months (3 to 35 months). Hematochezia recurred in 4 patients, but were easily treated with 1 APC course. CONCLUSION: APC is an effective treatment of hemorrhagic radiation proctitis, with a success rate of 87%. Endoscopic improvement is usual. It seems to be possible to limit the risk of complications by using low power setting.

Aged↗
PubMed2003

Argon plasma coagulation for radiation proctitis.

Radiation proctitis is a well-recognized complication following radiotherapy for pelvic malignancy. This study was designed to compare the efficacy and complications of argon plasma coagulation (APC) using the power setting of 50 W vs. 60 W in a group of patients with radiation proctitis. Forty-two patients were randomized to undergo APC using the electrical power setting of 60 W (23 patients, group A) or 50 W (19 patients, group B). Patients were asked to estimate the severity of major symptoms before and after APC using a scoring system graded 0-4. The score of major symptoms before and after APC, mean duration of the procedure, number of sessions, side effects/complications were noted. Statistical analysis was performed using Fisher's Exact Test and the 2-tailed p value less than 0.05 was considered statistically significant. A significant improvement of major symptoms was noted in all patients treated with APC, irrespective of the wattage we used, apart from the presence and severity of tenesmus. The mean number of treatment sessions to achieve control of bleeding was 1.34 for group A and 1.9 for group B and the mean time of treatment sessions was significantly shorter for group A (15 min vs. 17 min for group B). No significant differences in early side effects and long term complications between the two groups were evidenced. We can conclude that there is no statistical significance concerning efficacy and side effects of APC application between the 60W and 50W power setting, but the number of sessions and duration of the procedure tend to differ significantly. Rectal stenoses have been described only in patients treated with higher power settings.

Aged↗
PubMed2004

[Treatment of chronic postirradiation proctitis with argon plasma coagulation ].

Chronic radiation proctitis calls for a disease of the rectum due to irradiation of pelvic malignancies. The results of treatment of 8 patients with hematochezia from chronic radiation proctitis are presented here. They were treated with argon plazmakoagulation during 1-4 sessions. Hematochezia has disappeared in all cases. Rectal pain was the reason for hospitalization in one case. After the treatment, improved quality of live was claimed by all patients.

Aged↗
PubMed1992

[5-aminosalicylic acid enema (Pentasa) versus hydrocortisone acetate foam (Proctocort) for the treatment of outbreaks of proctitis and cryptogenetic proctosigmoiditis. A comparative randomized multicenter trial].

The therapeutic efficacy of 1 g 5-aminosalicylic acid enema was compared with that of 90 mg hydrocortisone acetate foam following daily rectal administration to patients with idiopathic proctitis or proctosigmoiditis during two weeks. A total of 199 patients (103 5-aminosalicylic acid, 96 hydrocortisone acetate) were included in a randomized, multicenter trial. Endoscopic and clinical remission was seen in 67 and 69 percent of the 5-aminosalicylic acid-treated and in 50 and 45 percent of the hydrocortisone acetate-treated patients (P less than 0.05), respectively. Mild side effects were seen in 10.7 percent of the 5-aminosalicylic acid-treated patients and in 3.1 percent of the hydrocortisone acetate-treated patients (P = 0.05). After 2 weeks, 5-aminosalicylic acid enemas are more effective than hydrocortisone foam for topical treatment of patients with idiopathic proctitis or proctosigmoiditis.

Adolescent↗
PubMed1992

Aminophylline suppository-induced acute proctitis.

A 9-yr-old boy revealed anal hemorrhage after administration of an aminophylline suppository. Proctosigmoidoscopy demonstrated edema of the rectal mucosa with hyperemia and petechiae. We performed a provocation test and obtained the diagnosis of aminophylline suppository-induced acute hemorrhagic proctitis. One should recognize that acute hemorrhagic proctitis is a rare but important side effect of aminophylline suppositories, because they are commonly used for asthmatic children.

Acute Disease↗
PubMed2006

Lymphogranuloma venereum proctitis: An emerging sexually transmitted disease in HIV-positive men in the Netherlands.

A recent outbreak of lymphogranuloma venereum (LVG) proctitis caused by Chlamydia trachomatis serovar L2 has been detected in HIV-positive men in the Netherlands and Belgium. This sexually transmitted disease (STD), which is well known and frequently occurring in tropical countries, was quite unusual in Europe until 2003. STDs with ulcerative lesions, such as LGV, facilitate transmission of other microorganisms, including HIV and hepatitis C. This in combination with risky sexual behavior, such as unprotected anal sexual intercourse or use of sex toys, increases the risk of blood-blood contact and hence the risk of contracting multiple STDs. Two cases of patients who in a short time period contracted multiple STDs, including LGV proctitis, is presented.

Anti-Bacterial Agents↗
PubMed1991

[Idiopathic ulcerative proctitis. Clinical presentation and endoscopic outcome].

Endoscopic information was obtained for 52 patients with ulcerative proctitis (23 F, 29 H) seen during a ten-year period. The median follow-up was 68 +/- 8 months. During the first referral period (38 patients experienced a first attack), endoscopic particularities were available: inflammation involved the anal mucosa above the dental line (n = 16), the whole circumference of rectal mucosa (n = 19) or the anterior wall exclusively (n = 33). The upper limit was 12.2 +/- 0.6 cm from the anal verge. Inflammatory lesions were higher in circumferencial conditions, when patients were older (late onset disease) but sex and ethnic state did not influence results of endoscopic presentation. Exulcerations or superficial ulcers were visualized in 16 and spontaneous bleeding in 43. Forty-five patients achieved clinical accuracy after 9.4 +/- 1 ms, but 32 only a complete endoscopic remission. Mean number of relapses was 3.6 +/- 0.4; 13 patients experienced a single attack. During relapses, inflammation was stable in 11 of 38 patients. Extension to the rectum in rectosigmoid junction, and sigmoid and above by 6, 14, and 7 patients respectively. After 5 years follow-up, the cumulative risk of further extension was 37 percent and 13 percent, respectively. Low abdominal pain, an family history of ulcerative colitis, and high inflammatory lesions at referral were significantly associated with a higher risk of extension. Cancer did not occur and not surgery was necessary during the follow-up. Idiopathic proctitis is perhaps at the "benign end" of the spectrum of ulcerative colitis. Nevertheless, its endoscopic particularities should be noticed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Comparative analysis of systemic immunological parameters in ulcerative colitis and idiopathic proctitis: effects of sulfasalazine in vivo and in vitro.

Comparative analysis of the systemic immunity revealed similarities between ulcerative colitis and idiopathic proctitis. In the active stage of both diseases, circulating complement receptor positive cells were increased whereas T-cell percentages and lymphocyte functions were decreased. In severe forms of ulcerative colitis and idiopathic proctitis circulating EAC-phagocytosing esterase positive cells, indicative of activated monocytes, were demonstrated. Successful treatment with salicylazosulfapyridine (SASP) reversed these immunological changes. Incubation of SASP and its metabolites with leucocytes from patients and control subjects, in concentrations similar to those demonstrated in sera from patients treated with SASP, did not alter the immunological changes.

Adult↗
PubMed1985

[Segmental chlamydia proctitis].

A case report is given of a 28 year old homosexual suffering from segmental proctitis caused by Chlamydia. The patient had watery diarrhea and fever since 3 weeks. Stool specimen testing was negative in regard to Salmonella, Shigella and worm eggs. Infection with N. gonorrhoea, Herpes simplex virus, Toxoplasma gondi, Yersinia and M. tuberculosis could be excluded. Serological testing yielded results suggestive of an old lues infection successfully treated. On histological examination typical reticulocytary suppurating granuloma were found. Therapy of choice of Chlamydia-proctitis is tetracyclines.

Adult↗
PubMed1984

Chlamydial proctitis--unusual presentation as a symptomatic vaginal mass.

Chlamydial cervicitis and salpingitis are being increasingly diagnosed and reported, but chlamydial proctitis is an unusual problem to be found in gynecologic practice. In the reported patient who gave a history of rectal intercourse and presented with a symptomatic vaginal mass, a diagnosis of chlamydial proctitis was made on the basis of biopsy histology, specific monoclonal antibody-immunoperoxidase chlamydia assay, and response to doxycycline therapy.

Adult↗
PubMed1982

Ischemic proctitis.

The rectum is rarely involved in ischemic colitis because of its abundant collateral blood supply. Thus, other forms of inflammatory intestinal disease, such as antibiotic associated or infectious colitis, are considered to be more likely if the rectum is inflamed. Yet, collateral flow develops slowly. Therefore, ischemic proctitis does occur in instances of sudden occlusion of the major blood supply to the rectum, such as after an aortic operation. The histopathology of this condition does not differ from that of infectious colitides, and the diagnosis of ischemic colitis can only be confirmed after careful culturing and assessment of the stool for clostridial toxins. Penile Doppler pressure measurements, as demonstrated in the patient presented herein, may be a simple, noninvasive method of inferring rectal blood flow and, therefore, aid in the diagnosis of ischemic proctitis.

Biopsy↗
PubMed1995

[Proctitis caused by Chlamydia trachomatis].

The authors report a case of a 32-year-old patient who has been treated for idiopathic proctitis for 10 years. The inflammation did not react to Salazopyrin and corticosteroid therapy. Significant stenosis has developed. The probability of Chlamydia infection has emerged because of the atypical morphological appearance and therapy resistance of the process. The Chlamydia infection was verified by serological examinations and direct immunofluorescent detection of the pathogen taken from biopsy specimen. The proctitis has been cured by Doxycyclin and roxithromycin therapy. The authors call attention to the different diagnostic significance of the disease considering that strictures requiring surgical operation can develop in cases being unrecognised and treated inadequately. The case is the first report of the disease in Hungary.

Adult↗
PubMed2003

Rectal tissue, plasma and urine concentrations of mesalazine after single and multiple administrations of 500 mg suppositories to healthy volunteers and ulcerative proctitis patients.

OBJECTIVE: Patients with ulcerative proctitis may have rectal mucosal properties different from healthy volunteers. This project compared the pharmacokinetics of rectally administered mesalazine in these two populations. METHODS: In two separate studies, nine patients with ulcerative proctitis and 16 healthy volunteers received a single 500 mg mesalazine suppository and then 500 mg every 8 h for 5 days. Blood samples were collected for 12 h in healthy volunteers and 30 h in patients, and urine for 24 h in healthy volunteers and 30 h in patients. Rectal biopsies were performed 8 h after the last dose. RESULTS: After a single dose to patients, mean mesalazine half-life (s.d.) was 5.0 (3.6) h. At steady-state, means (s.d.) were 89.1 (78.9) ng/mL for C(min), 361.1 (240.8) ng/mL for C(max), and 7.1 (7.3) h for half-life. Mean (range) rectal mesalazine concentrations were 167 (1.4-541.6) ng/mg tissue. After a single dose in healthy volunteers, mean (s.d.) half-life was 4.0 (4.7) h. At steady-state, means (s.d.) were 22.4 (61.6) ng/mL for C(min), 359.4 (166.3) ng/mL for C(max), and 0.9 (0.5) h for half-life. CONCLUSION: Mesalazine is released in the rectum of patients, with a bioavailability of about 40%. Tissue distribution is also appreciable. Both parameters appear higher than in healthy volunteers.

Adult↗
PubMed1979

Methylene blue dye spraying method in patients with ulcerative proctitis: a comparative study with morphological findings and functional capacity of the rectal epithelium.

Methylene Blue dye spraying method is currently used in the endoscopic assessment of the colonic mucosa of patients with chronic ulcerative proctocolitis. We have assessed the validity of this method in the evaluation of the functional capacity of the rectal mucosa in 17 patients with ulcerative proctitis and in 5 normal subjects. The ionic transmucosal fluxes of Na+ and K+ and the potential difference were used as parameters of the mucosal function. Our results indicate that methylene blue dye spraying method can be useful in the functional assessment of the rectal epithelium, especially for differentiating normal subjects and patients with mild ulcerative proctitis.

Adolescent↗