title: Ulcerative proctitis: a review of pharmacotherapy and management.
abstract: BACKGROUND
  Ulcerative proctitis (UP) is a common presentation of ulcerative colitis (UC).
  
  
  OBJECTIVE
  To summarize available literature on up-to-date management and pharmacotherapy of UP patients.
  
  
  METHODS
  Extensive Medline/Embase literature search was performed to identify relevant articles.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Semmelweis University, First Department of Medicine, H1083 Budapest, Koranyi S 2A, Hungary. kislakpet@bel1.sote.hu
authors.forename: Peter Laszlo
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Laszlo
authors.initials: L
authors.lastname: Lakatos
mesh_terms: D000284:Administration, Oral; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000150:complications; D018849:Controlled Clinical Trials as Topic; D004733:Enema; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D019804:Mesalamine / Q000008:administration & dosage / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D011349:Proctitis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D013488:Suppositories
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D013488:Suppositories; D019804:Mesalamine