Lakatos Peter Laszlo, Lakatos Laszlo
Semmelweis University, First Department of Medicine, H1083 Budapest, Koranyi S 2A, Hungary.
Expert Opin Pharmacother. 2008 Apr;9(5):741-9. doi: 10.1517/14656566.9.5.741.
Ulcerative proctitis (UP) is a common presentation of ulcerative colitis (UC).
To summarize available literature on up-to-date management and pharmacotherapy of UP patients.
Extensive Medline/Embase literature search was performed to identify relevant articles.
RESULTS/CONCLUSION: Topical medication with rectally administered 5-aminosalicylic acid (5-ASA)/corticosteroid suppositories or enemas is effective treatment for most UP patients. Locally administered 5-ASA is more efficacious than oral compounds. The combination of topical 5-ASA and oral 5-ASA or topical steroids should be considered for escalation of treatment. Maintenance treatment is indicated in all UC cases. 5-ASA suppositories are suggested as first-line maintenance therapy if accepted by patients, although oral 5-ASA as maintenance therapy might prevent proximal extension of the disease. After re-assessment, chronically active patients refractory or intolerant to 5-ASAs and corticosteroids may require immunomodulators or biological therapy. Exceptional cases may require a proctocolectomy.
溃疡性直肠炎（UP）是溃疡性结肠炎（UC）的常见表现形式。
总结关于UP患者最新管理和药物治疗的现有文献。
进行广泛的Medline/Embase文献检索以识别相关文章。
结果/结论：直肠给药的5-氨基水杨酸（5-ASA）/皮质类固醇栓剂或灌肠剂进行局部用药对大多数UP患者是有效的治疗方法。局部给药的5-ASA比口服制剂更有效。对于治疗升级应考虑局部5-ASA与口服5-ASA或局部类固醇联合使用。所有UC病例均需维持治疗。如果患者接受，建议使用5-ASA栓剂作为一线维持治疗，尽管口服5-ASA作为维持治疗可能预防疾病近端扩展。重新评估后，对5-ASA和皮质类固醇难治或不耐受的慢性活动患者可能需要免疫调节剂或生物治疗。特殊情况可能需要行直肠结肠切除术。
