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Spread and distribution of 5-ASA colonic foam and 5-ASA enema in patients with ulcerative colitis

Digestive Diseases and Sciences volume 37, pages 1890–1897 (1992)Cite this article

Abstract

Rectal treatment with enemas, foams, and suppositories is the most efficient method of delivering an adequate quantity of locally active drugs to the distal colon. In a pilot study carried out by colonoscopy in four patients, it was observed that 4 g 5-ASA in 20 ml foam spread up or beyond the splenic flexure and more extensively than 2 g 5-ASA in 10 ml foam. Therefore we have undertaken a study in order to compare by scintigraphy the colonic distribution of 4 g 5-ASA foam versus 4 g 5-ASA in 100 ml liquid enemas in 10 patients with ulcerative colitis using a crossover randomized design. Both preparations were labeled with 100 MBq [99mTc] sulfur colloid before administration. Anterior scans were taken at intervals for 4 hr. Activity, expressed as a percentage of total radioactivity, was measured in the rectum, sigmoid, descending, transverse, and ascending colon. Six patients had the same extent of spread with the two formulations; in three patients with foam and in one patient with enema a greater spread was observed. the foam reached the upper limit of disease in all cases, while enema failed in two cases. The maximum spread with foam was observed within 30 min in nine of 10 patients compared with seven of 10 after enema. Compared to enema, foam distributes more uniformly and seems to persist longer in the descending and sigmoid colon. The 5-ASA colonic foam shows some more favorable characteristics than enema for the local treatment of left-sided ulcerative colitis.

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Affiliations

  1. Istituto di Clinica Medica e Gastroenterologia, Università di Bologna, Servizio di Medicina Nucleare, Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138, Bologna, Italy

    Massimo Campieri MD, Claudio Corbelli MD, Paolo Gionchetti MD, Corrado Brignola MD, Andrea Belluzzi MD, Giulio Di Febo MD, Paolo Zagni MD, Gabriele Brunetti MD, Mario Miglioli MD & Luigi Barbara MD

Authors
  1. Massimo Campieri MD
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  2. Claudio Corbelli MD
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  3. Paolo Gionchetti MD
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  4. Corrado Brignola MD
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  5. Andrea Belluzzi MD
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  6. Giulio Di Febo MD
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  7. Paolo Zagni MD
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  8. Gabriele Brunetti MD
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  9. Mario Miglioli MD
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  10. Luigi Barbara MD
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Additional information

This work was supported in part by Bracco S.p.A (Milan, Italy).

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Campieri, M., Corbelli, C., Gionchetti, P. et al. Spread and distribution of 5-ASA colonic foam and 5-ASA enema in patients with ulcerative colitis. Digest Dis Sci 37, 1890–1897 (1992). https://doi.org/10.1007/BF01308084

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  • DOI: https://doi.org/10.1007/BF01308084

Key Words

  • 5-ASA
  • rectal foam
  • suspension enema
  • retrograde spread
  • biodistribution study
  • scintigraphic study