Features of rectal treatment of inflammatory bowel diseases

The article provides information on local inflammatory bowel diseases therapy, the peculiarities of the use of various rectal forms of anti-inflammatory drugs. The basic drug for the treatment of patients with inflammatory bowel diseases is 5-ASA, used both topically or orally, and in combination, including as part of complex therapy. The most common form of the initial stage of ulcerative colitis is proctosigmoiditis or left-sided colitis. All three forms of 5-ASA for rectal administration (candles, enemas and foam), according to clinical studies that evaluated the frequency of achieving clinical remission of proctitis, were equally effective. The introduction of mesalazine foam through the rectum acts directly on the mucous membrane of the end parts of the intestine. Due to the high adhesive ability of the foam, the drug 5-ASA can "stick" to the mucous membrane, which ensures long-term contact of the drug with the affected area of the intestine. In addition, the foam, having the ability to diffuse, spreads from the injection site proximally along the course of the colon, gradually expanding to the maximum possible volume. At the same time, the duration of contact (exposure) of the drug with the intestinal mucosa increases the effectiveness of its action. A small volume of a single dose of rectal foam, compared with enemas, contributes to better patient tolerance and higher adherence to treatment. In mild and moderate course of ulcerative proctitis, as well as left-sided ulcerative colitis, rectal preparations of 5-ASA are the first line of therapy. For common and total colitis, it is advisable to use a combination of rectal and oral forms of 5-ASA. Detailed recommendations of the doctor on the administration of the drug help to comply with the treatment regimen and significantly increase the effectiveness of therapy.

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