Abstract
The optimal medical treatment of IBD is tailored according to the patient's needs. Topical treatment of IBD means the direct application of effective medication to the affected area of the colon by rectal administration.
Some systemically (per oral) treatment can also cause topically, but it is not our issue.Rectally administered topical agents have a proven efficacy in the treatment of distal colitis and proctitis. The side effects associated with treatment are not commonly seen.
In spite of this, topical treatment is seldom used. Topical mesalazine suppositories are effective against proctitis and enemas for left sided ulcerative colitis.
The clinical results associated with topical mesalazine suppositories are better than oral 5- ASA's and are preferred to topical steroids with better clinical, endoscopic as well as histological results. Resisitant distal colitis is very difficult to treat and requires a combination of drugs: per oral mesalazine, systemic steroids or immunosuppressants and anti TNFα alfa blockers that do not always yield satisfactory treatment results.
It is describe other less used topical treatment. The effects of these drugs needs futher investigations and double blind prospective trials.
The article also concerns the topical treatment of Crohn's disease, pouchitis and cuffitis.