PubMed · 59560
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J H Comroe. 1976. Whodunit (and why). Part II.. https://doi.org/10.1164/arrd.1976.114.1.229
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The remission period of patients with ulcerative colitis was extended by long term treatment with 2-3 g sulphasalazine daily. Proctocolectomy should be performed if no remission can be obtained on continued medical therapy. Moreover, in these cases the operation is suggested to avoid the unwanted side effects of the drugs and the increased risk of cancer.
During a normal and an accelerated intestinal transit, in seven healthy volunteers, the recoveries of salicylazosulphapyridine (SASP) and its split products sulphapyridine (SP) and 5-aminosalicylic acid (5-ASA) were determined in urine and faeces. The azo-reduction of SASP and consequently the recovery of 5-ASA in the faeces was found to be substantially decreased during an accelerated intestinal transit. In addition, in 18 patients with inflammatory disease of the colon during maintenance therapy of SASP it could be demonstrated that the serum SP levels were related to the diarrhoeal state and did not correlate with disease activity. As recent studies have reported that 5-ASA is possibly the active therapeutic moiety of SASP, the ineffectiveness of SASP therapy in patients with active colitis may be ascribed to the reduced azo reduction of SASP as the result of profuse diarrhoea.
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