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. 2014 Jan;8(1):80-4.
doi: 10.1016/j.crohns.2013.07.003. Epub 2013 Aug 12.

Point-counterpoint: Are we overtreating patients with mild ulcerative colitis?

Akbar K Waljee  1 , Ryan W Stidham  2 , Peter D R Higgins  2 , Sandeep Vijan  3 , Sameer D Saini  4
Affiliations

Point-counterpoint: Are we overtreating patients with mild ulcerative colitis?

Akbar K Waljee et al. J Crohns Colitis. 2014 Jan.

Abstract

A 26 year-old man with a history of mild, left-sided ulcerative colitis presents to your clinic for a routine follow-up appointment. He initially presented approximately 5 years ago with intermittent rectal bleeding and diarrhea, which led to a diagnostic colonoscopy. His symptoms resolved in 1–2 weeks with a combination of oral and rectal mesalamine, and you have seen him annually since that time. At today’s visit, he readily admits that he fails to take his medication on a regular basis, opting instead to use oral mesalamine as needed in response to symptoms. He estimates that he uses the medication for several weeks at a time, once or twice a year. Currently, he is having 1–2 formed bowel movements a day, with no blood and no nocturnal symptoms. His laboratory studies, including inflammatory markers and complete blood count, are normal. Upon questioning, you learn that he sees little benefit in taking a daily medication. His symptoms flare infrequently and improve quickly with initiation of mesalamine. He asks you if continuous, long-term mesalamine use confers any advantage or disadvantage over intermittent use based on symptoms, as he is currently doing.

Keywords: 5-ASA; Inflammatory Bowel Disease; Mesalamine; Ulcerative colitis.

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Conflict of interest statement

Conflict of interest

None.

References

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