Case 6. Left ulcerative colitis

 

TOPICAL TREATMENT WITH MESALAZINE ENEMAS

A patient diagnosed with left ulcerative colitis 10 years ago. Treatment initially consisted of oral and topical mesalazine, though sustained clinical remission was not achieved and corticosteroids often proved necessary. As a result, therapy was started with azathioprine. The patient experienced some clinical improvement, with partial response, though endoscopically left side disease persisted, with long ulcerations of some depth.

 

Figure 1
 

Due to the presence of severe left side disease, the importance of topical mesalazine was stressed, and patient collaboration to assure adherence to therapy was obtained. One month after correct topical medication, clear endoscopic improvement was observed.

 

Figure 2. Mucosal healing of most of the previous ulcerative lesions, with the persistence of a distal annular segment exhibiting inflammatory disease.
 

After clinical and endoscopic confirmation of the effect of the medication, the patient increased adherence to therapy, recognizing the poor initial compliance. Topical medication in combined or not with other drug substances may be highly effective for the management of left ulcerative colitis, though patient adherence to treatment must be ensured.

 
 

PÁGINA ANTERIOR: << Case 5. Stricturing ileal Crohn’s disease
PÁGINA SIGUIENTE: >> Case 7. Long-evolving ulcerative colitis with sustained endoscopic-histological inflammation
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