Treatment Options for Chronic Sigmoid Colitis

Chronic sigmoid colitis refers to long-term inflammation of the sigmoid colon, which is located at the end of the large intestine just above the rectum. Due to its anatomical position, localized treatments such as enemas are often effective in managing symptoms.

For cases related to ulcerative colitis, a commonly prescribed treatment is mesalamine enema. This medication helps reduce inflammation directly in the affected area. In addition to the enema form, oral mesalamine or sulfasalazine may also be used. Both belong to the class of drugs known as aminosalicylates. While mesalamine tends to be more expensive, it generally causes fewer side effects compared to sulfasalazine, which is more affordable but associated with a higher risk of adverse reactions.

Alternative local therapies include corticosteroid or herbal enemas, which can help control inflammation and provide symptom relief. If local therapy combined with oral aminosalicylates proves ineffective, systemic corticosteroids—either taken orally or administered intravenously—may be required.

In situations where conventional treatments fail to produce satisfactory results, immunosuppressive medications such as azathioprine or 6-mercaptopurine might be considered. Biological therapies like infliximab have also shown effectiveness in managing moderate to severe cases. Once a remission phase is achieved, maintenance therapy is essential to prevent relapse and sustain long-term remission.

Managing chronic sigmoid colitis typically involves a stepwise approach, tailored to each individual's response and disease severity. Early diagnosis and consistent follow-up play a crucial role in achieving better outcomes.