Spreading Characteristics of Proprietary Rectal Steroid Preparations

Abstract

It has long been recognised that the local application of corticosteroids is of considerable value in the treatment of patients with ulcerative colitis. In 1956 Truelove described a method of intrarectal infusion of steroids using a drip set and a rubber catheter. By 1960 the prednisolone-21-phosphate enema, the ‘Predsol’ enema, was in production and shown in a double blind trial by Matts (1960) to be an effective treatment. In the same trial a preliminary study was carried out, substituting 100 ml of a dilute solution of barium for the enema fluid. This study indicated that such an enema can spread a considerable way into the colon. There are two main disadvantages with the ‘Predsol’ enema. First, it is uncomfortable, and secondly many patients find it difficult to retain even on elevation of the foot of the bed.