Absorption of an oral contraceptive gestagen in ulcerative colitis before and after proctocolectomy and construction of a continent ileostomy.
Plasma 1-norgestrel (1-Ng) levels after administration of a common oral contraceptive in fertile women (mean age 29 +/- 5 yrs) with mild ulcerative colitis before or after proctocolectomy with a conventional ileostomy or a continent ileostomy reservoir were determined and compared to those of a group of healthy volunteers serving as controls. Before operation, peak and 10-hour levels of 1-Ng were not statistically different from control. Levels in patients with either type of ileostomy were slightly lower than controls, but were only statistically significantly lower in patients with continent ileostomy (p less than 0.05). In a subgroup of patients studied both before and after proctocolectomy with construction of a continent ileostomy, there was a slight reduction in peak and 10-hour levels compared to control. After administration of the pill directly into the reservoir, significant levels of 1-Ng in plasma were found with peak and 10-hour levels approximately one-half of those achieved after oral administration. Although the material is small, it suggests that patients with mild ulcerative colitis and with small ileal resections (8.8 +/- 8 cm) can use combined contraceptive pills containing 1-norgestrel with confidence. Caution should be exercised, however, in prescribing "mini-pills" to patients after proctocolectomy and ileal resection.
D000328:Adult; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000097:blood* / Q000601:surgery; D003277:Contraceptives, Oral, Combined / Q000097:blood; D005260:Female; D006801:Humans; D007081:Ileostomy; D007408:Intestinal Absorption; D007700:Kinetics; D016912:Levonorgestrel; D009644:Norgestrel / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood
D003277:Contraceptives, Oral, Combined; D009644:Norgestrel; D016912:Levonorgestrel