In mild–moderate ulcerative colitis flare, add topical mesalamine or increase oral dose? скачать в хорошем качестве

In mild–moderate ulcerative colitis flare, add topical mesalamine or increase oral dose?

Management of mild to moderate Ulcerative Colitis flares often raises a practical treatment decision: should clinicians increase the oral Mesalamine dose alone, or combine oral therapy with topical formulations? Many patients experience symptom recurrence despite standard oral dosing, and the instinct is often to escalate the oral dose because it is simple and generally preferred by patients. However, this decision becomes more complex when considering disease extent, treatment adherence, and tolerability. Evidence suggests that combining oral and topical mesalamine improves remission and symptom control more consistently than oral dose escalation alone, particularly in left-sided or more extensive disease. This discussion outlines a practical framework for deciding between combination therapy and oral dose escalation, emphasizing disease distribution, prior corticosteroid exposure, tolerability of topical therapy, and patient-specific risk factors. #Gastroenterology #UlcerativeColitis #InflammatoryBowelDisease #IBD #Mesalamine