| Theme |
Advanced Therapy Ulcerative Colitis |
| Title |
Topical Steroid Therapy in Ulcerative Colitis |
| Author |
Tadashi Yokoyama |
Department of Surgery I, Faculty of Medicine, The University of Tokyo |
| Author |
Masaru Shinozaki |
Department of Surgery I, Faculty of Medicine, The University of Tokyo |
| [ Summary ] |
Topical steroids should be used in proctitis or left-sided ulcerative colitis of mild or moderate form, in combination with sulfasalazine or 5-ASA alternatives. Topical therapy has also been incorporated into the regimen for severe disease and for postoperative proctitis in which the lower rectum is intact (ileal pouch-distal rectal anastomosis). However, only betamethasone enema and betamethasone suppositories are available in Japan, if treatment is done in the outpatient clinic. Several kinds of steroids and several formulations, including foam, are available in western countries. Usually, prednisolone metasulfo-benzoate 20mg or hydrocortisone 80-100mg are recommendated for enema use. Long-term use of topical steroids is often associated with systemic side-effects. Newer corticosteriod preparations, which are either not absorbed through the mucosa, or have a substantial first-pass hepatic metabolism, are usually associated with minimal systemic corticosteroid activity and are now available in some western countries. |