Chronic Bowel Disorders

Aminosalicylates:

MESALAZINE:

Indications: is an anti-inflammatory drug used to treat inflammation of the digestive tract ulcerative colitis and mild to moderate Crohn’s disease. Contraindications: severe hepatic impairment.

Dose and Administration: for ulcerative colitis 1-2 tablet 3 times daily before meals in acute attacks, for long treatment of ulcerative colitis 500mg 3 times daily. For Crohn’s disease 1-3 tablets 3 times daily. For enema use the content (4gm/60ml) per day.

SULPHASALAZINE:

Indications: treatment of mild to moderate and sever ulcerative colitis and maintenance of remission active Crohn’s disease also for rheumatoid arthritis. Contraindications: child under 2 years of age, asthmatic patients, and intestinal and urinary obstruction.

Dose and Administration: adults acute attack 1-2 gm 4 times daily until remission occurs, reducing to maintenance dose of 500mg 4 times daily. Children over 2 years acute attack 40-60mg/kg daily. Maintenance doses 20-30mg/kg daily.

Cortecosteroids:

BUDESONIDE:

Indications: ulcerative colitis involving rectal and recto-sigmoid disease. Contraindications: use of enemas and rectal forms in obstruction, bowel perforation, and extensive fistulas; untreated infection.

Dose and Administration: 1 enema at bedtime for 4 weeks.

Cytokine Inhibitors:  INFLIXIMAB:

Indications: inflammatory bowel disease, ankylosing spondylitis, and rheumatoid arthritis.

Contraindications: pregnancy, breast-feeding and sever infection.

Dose and Administration: adults over 18 years initially 5mg/kg if responding within 2 weeks of initial dose, then 5mg/kg 2 weeks and 6 weeks after initial dose.