Sucralfate enema in ulcerative rectosigmoid lesions

Abstract

To assess the efficacy of sucralfate enemas in distal colonic ulcerative lesions, 22 patients with radiation proctitis (n=8), idiopathic ulcerative proctitis (n=5), and solitary rectal ulcer (n=5) unresponsive to conventional medical therapy, and those with ulcerated and bleeding rectal polyps awaiting polypectomy (n=4) were studied. Enemas of sucralfate suspension (2 gm in 20 ml water) were administered twice daily for a period of three weeks. Clinical and sigmoidoscopic improvements were observed in 19 and 18 of the 22 patients, respectively (86 and 82 percent, respectively). No side effects were seen. The authors conclude that sucralfate enemas are useful in the treatment of ulcerative lesions of the rectosigmoid.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Nagashima R. Development and characteristics of sucralfate. J Clin Gastroenterol 1981;3(suppl 2):103–10.

    PubMed  Google Scholar 

  2. 2.

    Shea-Donohue T, Steel L, Montcalm E, Dubois A. Gastric protection by sucralfate: role of mucus and prostaglandins. Gastroenterology 1986;91:660–6.

    PubMed  Google Scholar 

  3. 3.

    Hollander D, Taranawski A, Krause WJ, Gergely H. Protective effect of sucralfate against alcohol induced gastric mucosal injury in the rat: macroscopic, histologic, ultrastructural and functional time sequence analysis. Gastroenterology 1985;88:366–74.

    PubMed  Google Scholar 

  4. 4.

    Hollander D. Efficacy of sucralfate for duodenal ulcers: a multicenter double blind trial. J Clin Gastroenterol 1981;3(suppl 2):153–7.

    Google Scholar 

  5. 5.

    Elsborg L. Oesophageal reflux disease: diagnosis, pathophysiology and treatment with special reference to the role of sucralfate. Scand J Gastroenterol 1987;22(suppl 127):101–9.

    Google Scholar 

  6. 6.

    Tryba M, May B. Acute treatment of severe haemorrhagic gastritis with high dose sucralfate. Lancet 1988;2:1304.

    Google Scholar 

  7. 7.

    Carling L, Kagevi I, Borvall E. Sucralfate enema (SUC)—effective in IBD? (letter) Endoscopy 1986;18:115.

    PubMed  Google Scholar 

  8. 8.

    Batman F. Arslan S, Telatar H. Effect of sucralfate in the treatment of solitary rectal ulcer (letter). Endoscopy 1988;20:128.

    Google Scholar 

  9. 9.

    Baron JH, Connell AM, Lennard-Jones JE. Variations between observers in describing mucosal appearances in proctocolitis. Br Med J 1964;1:89–92.

    Google Scholar 

  10. 10.

    Gilinsky NH, Burns DG, Barbezat GO, Levin W, Myers HS, Marks IN. The natural history of radiation induced proctosigmoiditis: an analysis of 88 cases. Quart J Med 1983;205:40–53.

    Google Scholar 

  11. 11.

    Nagashima R. Mechanisms of action of sucralfate. J Clin Gastroenterol 1981;3(suppl 2):117–27.

    PubMed  Google Scholar 

  12. 12.

    Danesh BJ, Duncan A, Russell RI. Is an acid pH medium required for the protective effect of sucralfate against mucosal injury? Am J Med 1987;83(suppl 3B):11–3.

    Google Scholar 

  13. 13.

    Bronner MH, Yantis PL. Intracolonic sucralfate suspension for postpolypectomy hemorrhage. Gastrointest Endosc 1986;32:362–3.

    PubMed  Google Scholar 

  14. 14.

    Dawson DJ, Khan AN, Miller V, Ratcliffe JF, Shreeve DR. Detection of inflammatory bowel disease in adults and children: evaluation of a new isotopic technique. Br Med J 1985:291:1227–30.

    Google Scholar 

  15. 15.

    Zahavi I, Avidor I, Marcus H, et al. Effect of sucralfate on experimental colitis in the rat (abstract). Gastroenterology 1987;92:1707.

    Google Scholar 

  16. 16.

    Goldstein F, Khoury J, Thornston JJ. Treatment of chronic radiation enteritis and colitis with salicylazosulphapyridine and systemic corticosteroids. Am J Gastroenterol 1976;65:201–8.

    PubMed  Google Scholar 

  17. 17.

    Yeoh EK, Horowitz M. Radiation enteritis. Surg Gynecol Obstet 1987:165:373–9.

    PubMed  Google Scholar 

  18. 18.

    Kochhar R, Sharma SC, Gupta BB, Mehta SK. Rectal sucralfate in radiation proctitis (letter). Lancet 1988;2:400.

    Google Scholar 

  19. 19.

    Kochhar R, Malik AK, Nanda V, Bhasin DK, Singh K, Mehta SK. Clinical spectrum of solitary rectal ulcer. Indian J Gastroenterol 1986;6:31–3.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to R. Kochhar M.D., D.M..

Additional information

Reprints will not be available.

About this article

Cite this article

Kochhar, R., Mehta, S.K., Aggarwal, R. et al. Sucralfate enema in ulcerative rectosigmoid lesions. Dis Colon Rectum 33, 49–51 (1990). https://doi.org/10.1007/BF02053202

Download citation

Key words

  • Sucralfate
  • Ulcerative proctocolitis
  • Radiation proctitis
  • Solitary rectal ulcer
  • Rectal polyp