Drug therapy for ulcerative colitis

Ulcerative colitis (UC) is an inflammatory destructive diseaseof the large intestine occurred usually in the rectum andlower part of the colon as well as the entire colon.Drugtherapy is not the only choice for UC treatment and medicalmanagement should be as a comprehensive whole.Azulfidine,Asacol,Pentasa,Dipentum,and Rowasa allcontain 5-aminosalicylic acid (5-ASA),which is the topicalanti-inflammatory ingredient.Pentasa is more commonlyused in treating Crohn's ileitis because Pentasa capsulesrelease more 5-ASA into the small intestine than Asacoltablets.Pentasa can also be used for treating mild tomoderate UC.Rowasa enemas are safe and effective intreating ulcerative proctitis and proctosigmoiditis.The sulfa-free 5-ASA agents (Asacol,Pentasa,Dipentum andRowasa) have fewer side effects than sulfa-containingAzulfidine.In UC patients with moderate to severe diseaseand in patients who failed to respond to 5-ASA compounds,systemic (oral) corticosteroids should be used.Systemiccorticosteroids (prednisone,prednisolone,cortisone,etc.)are potent and fast-acting drugs for treating UC,Crohn'sileitis and ileocolitis.Systemic corticosteroids are noteffective in maintaining remission in patients with UC.Serious side effects can result from prolonged corticosteroidtreatment.To minimize side effects,corticosteroids shouldbe gradually reduced as soon as the disease remission isachieved.In patients with corticosteroid-dependent orunresponsive to corticosteroid treatment,surgery orirnmunomodulator is considered.Irnmunomodulatorsused for treating severe UC include azathioprine/6-MP,methotrexate,and cyclosporine.Integrated traditionalChinese and Western medicine is safe and effective inmaintaining remission in patients with UC.