Advertisement

Clinical Pharmacokinetics

, Volume 20, Issue 3, pp 247–251 | Cite as

Retrograde Spread of Mesalazine (5-Aminosalicylic Acid)-Containing Enema in Patients with Ulcerative Colitis

  • Monique M. C. Tiel-van Buul
  • Chris J. J. Mulder
  • Eric A. van Royen
  • Ed. H. H. Wiltink
  • Guido N. J. Tytgat
Original Research Article

Summary

In order to investigate the retrograde spread in the colon and its relationship to the extent of the diseased area, the authors evaluated a 100ml enema of mesalazine (5-aminosalicylic acid, ‘Pentasa’) 1g in a consecutive series of 30 patients with ulcerative colitis.

The enema was labelled with 10 MBq 99mtechnetium-human serum albumin microcolloid. Sequential scintigraphic imaging was performed in all patients, and the results compared with the extension of the disease as found by colonoscopy. If the enema reached the entire affected area it was interpreted as ‘topically adequate’.

In 80% of the patients there was retrograde spread of the enema beyond the rectosigmoid, thus reaching the affected area in ulcerative colitis. No relationship was found between the extent of dispersion of the enema and the time of defecation prior to scintigraphy.

The authors conclude that a 100ml ‘Pentasa’ enema may be adequate for treatment of ulcerative colitis extending up to the splenic flexure.

Keywords

Ulcerative Colitis Mesalazine Splenic Flexure Pentasa Distal Ulcerative Colitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Azad Khan AK, Piris J, Truelove SC. An experiment to determine the active therapeutic moiety of sulphasalazine. Lancet 2: 892–895, 1977PubMedCrossRefGoogle Scholar
  2. Campieri M, Lanfranchi GA, Bazzocchi G, Brignola C, Sarti F, et al. Treatment of ulcerative colitis with high dose 5-amino salicylic acid enemas. Lancet 2: 270–271, 1981PubMedCrossRefGoogle Scholar
  3. Campieri M, Lanfranchi GA, Brignola G, Gionchetti P, Minguzz MR, et al. Retrograde spread of 5-aminosalicylic acid enemas in patients with active ulcerative colitis. Diseases of the Colon and Rectum 29: 108–110, 1986PubMedCrossRefGoogle Scholar
  4. Danish 5-ASA Group. Topical 5-aminosalicylic acid versus prednisolone in ulcerative proctosigmoiditis. Digestive Diseases and Sciences 6: 598–602, 1987CrossRefGoogle Scholar
  5. Farthing MJC, Rutland MD, Clark ML. Retrograde spread of hydrocortisone containing foam given intrarectally in ulcerative colitis. British Medical Journal 2: 822–824, 1979PubMedCrossRefGoogle Scholar
  6. Hardy JG, Lee SW, Clark AG, Reynolds JR. Enema volume and spreading. International Journal of Pharmaceutics 31: 151–155, 1983CrossRefGoogle Scholar
  7. Hay DJ. Spreading characteristics of proprietary rectal steroid preparations. In Wilson et al. (Eds) Radionuclide imaging in drug research, Croom Helm, London, 1982Google Scholar
  8. Hay DJ, Sharma H, Irving MH. Spread of steroid-containing foam after intrarectal administration. British Medical Journal 2: 1751–1753, 1979CrossRefGoogle Scholar
  9. Mulder CJJ, Tytgat GNJ, Wiltink EHH, Houthoff H-J. Comparison of 5-aminosalicylic acid (3g) and prednisolone phosphate sodium enemas (30mg) in the treatment of distal ulcerative colitis. Scandinavian Journal of Gastroenterology 23: 1005–1008, 1988PubMedCrossRefGoogle Scholar
  10. Swarbrick ET, Loose H, Lennard-Jones JE. Enema volumes an important factor in successful topical corticosteroid treatment of colitis. Proceedings of the Royal Society of Medicine 67: 753–754, 1974PubMedGoogle Scholar
  11. van Buul MMC, Mulder CJJ, Wiltink EHH, van Royen EA, Tytgat GNJ. Retrograde spread of therapeutic enemas in patients with inflammatory bowel disease. Hepato-Gastroenterology 36: 199–201, 1989PubMedGoogle Scholar
  12. van Hees PAM, Bakker JH, van Tongeren JHM. Effect of sulphapyridine, 5-aminosalicylic acid, and placebo in patients with idiopathic proctitis; a study to determine the active therapeutic moiety of sulphasalazine. Gut 21: 632–635, 1980PubMedCrossRefGoogle Scholar
  13. Weber J, Rasmussen CE. Stralingsbescherming, p. 90, Delftse Uitgevers Maatschappij b.v., Delft, 1985Google Scholar
  14. Wood E, Wilson CG, Hardy JG. The spreading of foam and solution enemas. International Journal of Pharmaceutics 25: 191–197, 1985CrossRefGoogle Scholar

Copyright information

© Adis International Limited 1991

Authors and Affiliations

  • Monique M. C. Tiel-van Buul
    • 1
  • Chris J. J. Mulder
    • 1
  • Eric A. van Royen
    • 1
  • Ed. H. H. Wiltink
    • 1
  • Guido N. J. Tytgat
    • 1
  1. 1.Departments of Nuclear Medicine, Gastroenterology-Hepatology and PharmacyAcademic Medical CentreAmsterdamThe Netherlands

Personalised recommendations