Efficacy of open-label bismuth subsalicylate for the treatment of microscopic colitis
Efficacy of open-label bismuth subsalicylate for the treatment of microscopic colitis
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DOI：
10.1016/s0016-5085(98)70629-8
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发表时间：
1998-01-01
期刊：
影响因子：
29.4
通讯作者：
Lee, EL
中科院分区：
文献类型：
--
作者：
Fine, KD;Lee, EL
背景和目标：显微镜下结肠炎综合征的发病机制尚不清楚，但可能涉及细菌、肠腔抗原和/或自身免疫。假设次水杨酸铋可解决显微镜下结肠炎中的腹泻和结肠炎症，因为其具有抗腹泻、抗菌和抗炎特性。13例显微镜下结肠炎患者（7例有上皮下胶原沉积，6例无）每天用8片262 mg次水杨酸铋咀嚼片治疗8周，记录患者每日排便次数，每例患者在治疗前后进行48小时粪便收集和24次乙状结肠软镜活检。结果：12例患者完成了试验。11例患者腹泻消退，粪便重量减轻。平均反应时间为2周，9例患者结肠炎消退，治疗前存在时，上皮下胶原增厚消失。完成试验的患者未发生任何副作用，治疗后随访7-28个月，9例患者未接受进一步治疗，2例患者恢复良好但需要重新治疗，1例患者继续腹泻，结论：次水杨酸铋治疗8周是安全的，耐受性良好，该方案似乎对治疗显微镜下结肠炎有效，值得在对照试验中进一步研究。
Background & Aims: The pathogenesis of the microscopic colitis syndrome is unknown but may involve bacteria, an intestinal luminal antigen, and/or autoimmunity, It was hypothesized that bismuth subsalicylate would resolve both diarrhea and colonic inflammation in microscopic colitis because it possesses antidiarrheal, antibacterial, and anti-inflammatory properties, Methods: Thirteen patients with microscopic colitis (7 with subepithelial collagen deposition and 6 without) were treated with eight chewable 262-mg bismuth subsalicylate tablets per day for 8 weeks, Patients recorded the frequency of bowel movements daily, Forty-eight-hour stool collections and flexible sigmoidoscopy with 24 biopsies were performed before and after treatment in each patient. Results: Twelve patients completed the trial. Eleven patients had a resolution of diarrhea and a reduction in fecal weight. The average time to respond was 2 weeks, In 9 patients, colitis resolved, When present before treatment, subepithelial collagen thickening disappeared. Those completing the trial experienced no side effects, Posttreatment follow-up for 7-28 months shows that 9 patients remain well having undergone no further treatment, 2 are well but required retreatment, and 1 has continued diarrhea, Conclusions: Bismuth subsalicylate treatment for 8 weeks is safe and well tolerated, This regimen appears to be efficacious for the treatment of microscopic colitis and is worthy of further study in a controlled trial.