Clinical Gastroenterology Vol.16 No.10(4-7)

Theme The Newest Strategies for Severe Ulcerative Colitis
Title New Therapeutic Strategies for Severe Ulcerative Colitis
Publish Date 2001/09
Author Tomoyuki Tsujikawa Second Department of Internal Medicine, Shiga University of Medical Science
Author Tadao Bamba Second Department of Internal Medicine, Shiga University of Medical Science
[ Summary ] Corticosteroids are commonly prescribed for treatment of moderate to severe ulcerative colitis. However, about 40% of severe colitis cases display steroid resistance. Steroids have numerous adverse effects, that preclude their long term use. Several alternative therapeutic strategies have been created. Although use of intravenous tacrolimus(FK506) induced rapid remission in cases of steroid resistant severe ulcerative colitis, therapeutic drug monitoring is necessary. Enemas with Ecabet sodium, a nonabsorbable anti-gastric ulcer agent, proved to be a safe and useful adjuvant therapy for treating patients with mildly to moderately active ulcerative proctosigmoiditis. Germinated barley foodstuff(GBF) derived from the aleurone layer, scutellum and germ of germinated barley, contains a large quantity of fermentable dietary fiber, especially hemicellulose. Oral GBF therapy produced improvements in patients' clinical activity index score and increased stool butyrate concentrations. These therapies may have a place in management of ulcerative colitis, but controlled studies of each therapy are needed to demonstrate their efficacy in the treatment of ulcerative colitis.
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