Enema Therapy Research Articles

Mesalazine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in chronic inflammatory bowel disease.

Mesalazine (5-aminosalicylic acid; mesalamine), the active moiety of sulphasalazine (salazosulfapyridine), is available in specially formulated oral and rectal forms for the treatment of active ulcerative colitis of mild to moderate severity and for maintenance therapy during disease remission. Tablets or capsules coated with acrylic-based resin and tablets containing microgranules coated with ethylcellulose deliver mesalazine to the distal small intestine and colon, thus avoiding the need for the carrier, sulphapyridine, which is responsible for many of the adverse effects associated with sulphasalazine. Since mesalazine is released in the small intestine from some coated preparations in contrast to sulphasalazine, these oral formulations have therapeutic potential in Crohn's disease. A limited number of therapeutic trials suggest that orally administered mesalazine 1.5 to 2.4g daily is of similar efficacy to sulphasalazine 2 to 3g daily in patients with mild to moderate ulcerative colitis. The efficacy of mesalazine enemas has been more widely investigated, a dose of 1 to 4g once daily being consistently more effective than placebo and apparently similar to enemas of prednisone 25mg or oral sulphasalazine 3g. Initial results suggest that mesalazine 4g enemas may be more effective than those containing hydrocortisone 100mg. Mesalazine and sulphasalazine in approximately equivalent oral dosages are similarly effective in maintaining remission in ulcerative colitis. Orally administered coated mesalazine is generally well tolerated by about 85% of patients allergic to or intolerant of sulphasalazine, the remainder experiencing similar reactions to both drugs. Adverse effects of mesalazine enemas are confined to local irritation and effects resulting from enema-tip insertion. Thus, orally administered coated mesalazine is a suitable alternative to sulphasalazine in the treatment of patients with mild to moderate active distal ulcerative colitis and for maintaining remission particularly in patients allergic to or intolerant of sulphasalazine. In patients who find enema therapy acceptable, mesalazine enemas are effective and well tolerated.

Argon laser treatment of radiation proctitis.

Radiation therapy for malignant gynecologic disease and prostatic cancer has resulted in increased survival and cure rates. This modality has unfortunately produced debilitating radiation proctitis. Recently, five patients were seen with continuous rectal bleeding secondary to radiation disease of the rectum. Four of these patients were women who were being treated for cervical carcinoma and one was a man with prostatic cancer. These patients were refractory to steroid retention enemas, iron therapy, and benproperine enema therapy. Treatment was accomplished using the argon laser with a 300-micron fiber passed via flexible fiberoptic sigmoidoscope. The most proximal areas were treated first. One and a half watts at 0.5 pulses was used. Up to 50 pulses were delivered per therapy session. The fiber was placed in contact with the lesion and circumferentially for 0.5 cm surrounding each suspected area. Bleeding stopped in the four women after two sessions and in the man after four sessions.

Treatment of constipation in the elderly.

About $250 million a year are spent on laxatives in the United States, attributable in large portion to the elderly. However, before laxative therapy is started in these patients, adequate exercise, ample fluids, and a high-fiber diet should be recommended. If these measures are unsuccessful and underlying disease is excluded, laxative use may be considered. Selection of the most appropriate cathartic for the clinical situation is vital. Bulk-forming laxatives and lactulose are favored. Dietary and drug intake should be discussed with the patient and constipating items eliminated when possible. Enema therapy may be necessary to retrain or evacuate an atonic, constipated colon. The mnemonic, right, summarizes the major points in treating constipation.

かいよう性大腸炎のプロピオン酸ベクロメサゾンによる注腸療法

かいよう性大腸炎のプロピオン酸ベクロメサゾンによる注腸療法

Hypnotherapeutic explorations of early enema experience.

Abstract 6 cases of individuals who had been subjected to childhood enema therapy are presented. Each manifested sexual pathology, and are reviewed from a hypnoanalytic viewpoint.

The nonoperative treatment of meconium ileus by Gastrografin enema

Four consecutive cases of meconium ileus not complicated by volvulus, perforation, peritonitis, or atresia were treated by Gastrografin enema and parenteral fluid therapy. The enema was carried out successfully with complete relief of obstruction; no anesthesia was needed, and there were no major respiratory complications during the time of observation in the hospital.

Roentgenographic reversibility of ulcerative colitis in children treated with steroid enemas.

ROENTGENOGRAPHIC REVERSIBILITY OF ULCERATIVE COLITIS IN CHILDREN TREATED WITH STEROID ENEMASHENRY I. GOLDBERG, M.D., JOHN V. CARBONE, M.D. and ALEXANDER R. MARGULIS, M.D.Audio Available | Share