Treatment of ulcerative colitis

In recent years new standards for the treatment of ulcerative colitis have evolved. This review updates evidence based therapy for the various clinica l situations as well as some novel approaches. The literature search was ba sed on Medline, Cochrane database (CD-ROM) and handsearch of relevant paper s including quoted literature. There is clear-cut evidence-based support for the use of local 5-aminosalic ylates in mild/moderate distal and oral 5-aminosalicylates in extensive ulc erative colitis. The administration of corticosteroids is definitely indica ted in severe disease. Fulminant attacks are treated by intravenous cyclosp orine or colectomy. In chronic active disease azathioprine is probably help ful. Relapse prevention again is a domain of 5-aminosalicylates or, as a no vel development, E. coli Nissle. The various metaanalyses as well as the controlled trials performed in the various clinical situations typical for the manifestations of ulcerative co litis form a solid base of evidence to guide individual treatment decisions .