your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com

Approach to the initial management of mild to moderate ulcerative proctitis in adults

This algorithm represents our approach to managing ulcerative proctitis in adults, but other approaches are also reasonable. For example, some clinicians prefer to begin oral 5-ASA agents if topical (rectal) 5-ASA therapy does not result in improvement in symptoms rather than first adding topical (rectal) glucocorticoid therapy. Refer to UpToDate content on management of adults with ulcerative colitis for additional details.

5-ASA: 5-aminosalicylic acid; MMX: multi-matrix.

* Patients with ulcerative proctitis who responded to topical (rectal) mesalamine and who have ≤1 flare per year do not need maintenance therapy. For patients who responded to topical (rectal) mesalamine and who have >1 flare per year, we use a maintenance regimen of mesalamine suppository once daily. For patients who are unwilling to use daily topical 5-ASA therapy for long-term maintenance, we reduce the dosing frequency (eg, suppository every other day or twice weekly).

¶ Use of topical (rectal) glucocorticoids is not generally continued for >8 weeks because of the risk of systemic adverse effects.

Δ After remission is achieved with an oral 5-ASA agent, the initial dose may be continued (ie, >3 g daily), whereas decreasing the dose to 2 to 3 g daily is also a reasonable option.

Graphic 138644 Version 2.0