ABSTRACT
This should be considered in two phases: first, treatment of the acute attack to induce remission in new/relapsed disease, and second, the maintenance of remission.
Inducing remission
1. Sulphasalazine and 5-ASA preparations. These are used in mild to moderate disease, particularly when the colon is involved. The therapeutic effect may take 8-12 weeks, and so steroids in some form are often needed for adequate initial symptom control. The different formulations and adverse effects of 5-ASA are outlined in ‘Ulcerative colitis-medical and surgical management’ (p. 265). Preparations which release in the more proximal bowel (e.g. Pentasa) should have more benefit where the small bowel is affected.
