The first treatment for colitis, specifically when the colitis is limited to the rectum with mild or moderate activity, is typically a topical medication.
More specifically, a 5-ASA suppository (e.g., mesalazine 1 g/d) is considered the drug of first choice. According to the European Crohn's and Colitis Organisation (ECCO) guidelines, this treatment approach induces remission in 31-80% of patients, compared to only 7-11% in those treated with a placebo [7].
Here's a breakdown:
- Type of Colitis: Limited to the rectum with mild to moderate activity.
- First-line Treatment: Topical 5-ASA suppository (e.g., mesalazine 1 g/d) [7].
- Efficacy: Remission in 31-80% of patients [7].
- Guideline Support: ECCO EL 1b, RG B; DGVS EL A [7].
