5-ASA enemas for refractory distal ulcerative colitis. An open trial.

We conducted an open trial of 5-ASA enemas to determine the role of this drug in idiopathic distal ulcerative colitis resistant to conventional therapeutic approaches. Fifty-one such refractory patients were given 4 g 5-ASA enemas once nightly for 2 weeks, and the response was then assessed clinically and sigmoidoscopically. Overall, 29 patients (57%) had an excellent response, 11 (21%) had a satisfactory response, and a further 11 (21%) had a poor outcome. Two patients developed adverse reactions. Of the 11 patients with a poor response, nine remained dependent on oral prednisone for remission of their colitis. Although the role of 5-ASA enemas in the treatment of refractory distal ulcerative colitis remains to be determined, it appears that the drug appears to be beneficial for only a minority of patients dependent on systemic corticosteroids.