THE USE OF ORAL TOPICALLY ACTING GLUCOCORTICOSTEROIDS IN THE TREATMENT OF INFLAMMATORY BOWEL-DISEASE

GLUCOCORTICOSTEROIDS are the mainstay of treatment of active Crohn's d isease and ulcerative colitis. These drugs however carry important cos metic short-term side effects and when used long-term they induce seve re irreversible complications. Topically acting glucocorticosteroids, especially budesonide, have been designed to achieve local effect at t he site of inflammation without systemic effects of the drug. The firs t results of clinical trials are promising and budesonide has been sho wn to have an improved safety with almost comparable efficacy in compa rison with prednisolone. The optimal enema dose seems to be 2 mg/100 m l at night whereas 9 mg o.m. is the optimal dose to treat heal or righ t ileocolonic Crohn's disease, Topically acting GCS, like standard GCS are not effective for maintenance of remission of Crohn's disease or recurrence prevention after resection of the involved Crohn's segment.