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Proctitis - best practice
Siew Ng focussed on the best management of proctitis. Her talk showed that topical 5-aminosalicylates (5-ASA) are superior to oral 5-ASA or topical steroids, and used as first line treatment to induce remission. Recent data on UC rectal inflammation shows significantly greater remission rates with 5-ASA (81.5%) vs placebo (29.7%) suppositories (p<0.0001)1. Endoscopic remission rates for proctitis were 84% and 36% with 5-ASA vs placebo, while clinical remission rates were 68% vs 22%, respectively. If suboptimal response, escalation with a combination of topical 5-ASA and oral 5-ASA or topical steroids should be considered. Adherence, superimposed infection, appropriate diagnosis, and novel therapies should be reevaluated for refractory proctitis.