Ulcerative Colitis: Marteau P

Marteau P, Seksik P, Beaugerie L, Bouhnik Y, Reimund JM, Gambiez L, Flourié B, Godeberge P. · Service d'hépato-gastroentérologie, Hôpital Européen Georges Pompidou, 75015 Paris. · Gastroenterol Clin Biol. · Pubmed #15672566 No free full text.

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Marteau P. · No affiliation provided · Gut. · Pubmed #17124152 No free full text.

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Seksik P, Dray X, Sokol H, Marteau P. · AP-HP, Hôpital Saint-Antoine, Gastroenterology and Nutrition Department, University Pierre et Marie Curie, Paris, France. · Mol Nutr Food Res. · Pubmed #18384087 No free full text.

Abstract: The pathogenesis of inflammatory bowel disease (IBD) involves an interaction between genetically determined host susceptibility, dysregulated immune response, and the enteric microbiota. Ecological treatments including probiotics, prebiotics, and synbiotics are actively studied in Crohn's disease (CD), ulcerative colitis (UC) and pouchitis. We review herein the literature on the rational use of probiotics in IBD considering efficacy (as evaluated in randomized controlled trials), mechanisms of action and safety issues. A probiotic effect is strictly restricted to one defined strain and cannot be generalized from one to another. There is evidence of efficacy of some probiotic drugs in pouchitis (VSL#3), and in the prevention of recurrence of UC (Escherichia coli Nissle 1917). However, the evidence for efficacy of probiotic drugs in CD is still low as well as that of dietary ecological treatments. Despite an ecological (hopefully nutritional) treatment of IBD is promising, many questions remain unanswered and further clinical and fundamental studies are needed.

Dray X, Marteau P. · Département de pathologie digestive, hôpital Lariboisère, université Paris-7, 75010 Paris. · Rev Prat. · Pubmed #18320754 No free full text.

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D'Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, Lémann M, Marteau P, Rutgeerts P, Schölmerich J, Sutherland LR. · University Hospital Gasthuisberg, Leuven, Belgium. · Gastroenterology. · Pubmed #17258735 No free full text.

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Seksik P, Marteau P. · Service de Gastro-Entérologie, Hôpital Européen Georges Pompidou, Paris, France. · Therapie. · Pubmed #15199674 No free full text.

Abstract: Probiotics may modulate intestinal flora and immunity and are therefore studied in an attempt to modulate experimental colitis or human inflammatory bowel disease. We analysed randomised controlled trials performed using probiotics in humans with Crohn's disease, ulcerative colitis and pouchitis. Perspectives include the use of genetically modified micro-organisms to deliver anti-inflammatory agents to the gastrointestinal tract.

Marteau P, Seksik P, Shanahan F. · Gastroenterology Department, European Hospital Georges Pompidou, AP-HP & Paris V University, France. · Best Pract Res Clin Gastroenterol. · Pubmed #12617882 No free full text.

Abstract: In this chapter we summarize the clinical and experimental data which indicate that bacteria, especially from the endogenous microflora, play a role in the pathogenesis of Crohn's disease, ulcerative colitis and pouchitis. We review the clinical trials, focusing on randomized controlled trials which used antibiotics or probiotics to treat situations of IBD or prevent recurrence, and we discuss the future of this approach.

Marteau P. · Department of Gastroenterology, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, and Paris V University, France. · Endoscopy. · Pubmed #11778131 No free full text.

Abstract: This article reviews a selection of 50 papers on inflammatory bowel disease published between April 2000 and June 2001. The new information summarized here includes: the discovery of the association of the NOD2 gene with Crohn's disease; the role of bacteria and the modulating effects of probiotics; the inverse association of appendectomy and ulcerative colitis; progress in imaging based on magnetic resonance imaging and leukocyte scintigraphy; assessment of the value of anti-Saccharomyces cerevisiae antibodies in the screening of inflammatory bowel disease and differentiation between ulcerative colitis and Crohn's disease; and risk factors and management of dysplasia and cancer. This article does not review all therapeutic aspects, but focuses on smoking cessation; anti-tumor necrosis factor antibody treatments; the usefulness of measuring erythrocyte 6-thioguanine metabolite levels to optimize purine analogue therapy; strictureplasty; and the long-term results of ileoanal anastomosis.

Marteau P. · Gastroenterology Department, European Hospital Georges Pompidou, Paris, France. · Nestle Nutr Workshop Ser Clin Perform Programme. · Pubmed #11490630 No free full text.

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Marteau P. · Dept. of Gastroenterology, Laennec Hospital, Assistance Publique des Hôpitaux de Paris, and University of Paris V, France. · Endoscopy. · Pubmed #10696841 No free full text.

Abstract: This article reviews important papers on inflammatory bowel disease published between May 1998 and June 1999. It does not review every aspect of treatment, but focuses on the effects of anti-tumor necrosis factor antibodies on the inflammatory lesions. The new information summarized includes: the role of bacteria and the modulating effects of probiotics; the frequency of appendiceal orifice inflammation in ulcerative colitis; progress in imaging based on endoscopic ultrasonography, magnetic resonance imaging, and leukocyte scintigraphy; frequency and treatment of massive hemorrhage, viral superinfection, and persistent perineal sinus; and the pathogenesis, detection, and treatment of dysplasia and cancer.

Marteau P, Probert CS, Lindgren S, Gassul M, Tan TG, Dignass A, Befrits R, Midhagen G, Rademaker J, Foldager M. · Gastroenterology, Hopital Européen Georges Pompidou, 20 rue Leblanc, 75908 Paris cedex 15, France. · Gut. · Pubmed #15951542 links to  free full text

Abstract: BACKGROUND AND AIMS: Oral aminosalicylates are well established in the treatment of active mild/moderate ulcerative colitis (UC) when the disease is extensive (that is, beyond the splenic flexure). The majority of clinical symptoms relate to disease activity in the distal part of the colon and therefore this study was designed to investigate if adding a mesalazine enema to oral mesalazine has additional benefit for patients with extensive mild/moderate active UC. METHODS: A randomised double blind study was performed in 127 ambulatory patients. All received 4 g/day (twice daily dosing) oral mesalazine for eight weeks. During the initial four weeks, they additionally received an enema at bedtime containing 1 g of mesalazine or placebo. Disease activity was assessed using the ulcerative colitis disease activity index, with clinical and endoscopic signs at four and eight weeks. RESULTS: Remission was obtained in 44% (95% confidence interval (CI) 31%, 58%) of the mesalazine enema group (Me) and in 34% (95% CI 21%, 49%) of the placebo enema group (Pl) at four weeks (p = 0.31) and in 64% (95% CI 50%, 76%) of the Me group versus 43% (95% CI 28%, 58%) of the Pl group at eight weeks (p = 0.03). Improvement was obtained in 89% (95% CI 78%, 96%) of the Me group versus 62% (95% CI 46%, 75%) of the Pl group at four weeks (p = 0.0008) and in 86% (95% CI 75%, 94%) of the Me group versus 68% (95% CI 53%, 81%) of the Pl group at eight weeks (p = 0.026). CONCLUSION: In patients with extensive mild/moderate active UC, the combination therapy is superior to oral therapy. It is safe, well accepted, and may be regarded as firstline treatment.

Gornet JM, Couve S, Hassani Z, Delchier JC, Marteau P, Cosnes J, Bouhnik Y, Dupas JL, Modigliani R, Taillard F, Lemann M. · Department of Gastroenterology, Hôpital Saint-Louis, Paris, France. · Aliment Pharmacol Ther. · Pubmed #12869077 links to  free full text

Abstract: BACKGROUND: The efficacy of infliximab in ulcerative colitis (UC) and indeterminate colitis has been poorly assessed and preliminary results are conflicting. METHODS: The records of 30 patients treated with infliximab for ulcerative colitis (n=19) or indeterminate colitis (n=11) were reviewed. Infliximab was given because of steroid resistance (n=18), dependence (n=5) or intolerance (n=7); five patients had failed on cyclosporin; 19 patients had a severe flare-up. RESULTS: Median duration of follow-up was 10 months. In 28 patients with active disease, the response rate was 75% at day 7, with 43% having a complete remission, and 50% at month 1, with 32% having a complete remission. Among the 22 responders, the probability of relapse was 73% at month 6. The probability of complete remission without steroids, taking into account the re-treatment for relapse (n=11), was 57% (95% confidence interval (CI): 45% to 69%) at month 6. The probability of colectomy was 33% (95% CI: 23% to 43%) at month 12. In indeterminate colitis, response rate was only 50% at day 7 and 30% at month 1. Concomitant use of antimetabolite agents was associated with better results. CONCLUSIONS: Infliximab was able to induce a rapid response in some patients with UC or indeterminate colitis refractory to conventional treatment. Long-term results were less favourable, with frequent relapses, and about one-third of the patients required a colectomy.

Nahon S, Cadranel JF, Chazouilleres O, Biour M, Jouannaud V, Marteau P. · Service d'hépatogastroentérologie, centre hospitalier Le Raincy-Montfermeil, 10, avenue du Général-Leclerc, 93370 Montfermeil, France. · Gastroenterol Clin Biol. · Pubmed #19394180 No free full text.

Abstract: Liver disease is exceptional in patients with inflammatory bowel disease. The most common manifestation, sclerosing cholangitis, characterized by inflammation and fibrosis of the intra- and\or extrahepatic bile ducts, is unusual in patients with inflammatory bowel disease. Conversely, inflammatory bowel disease (mainly chronic ulcerative colitis) is not infrequent in patients with sclerosing cholangitis. Gallstone disease, portal vein thrombosis, and hepatic abscesses are complications directly related to inflammatory bowel disease. Drugs prescribed for the treatment of inflammatory bowel disease can be the cause of rare but potentially serious hepatic manifestations which must be recognized and detected early. Recent studies have demonstrated the role of purine analogues in the development of nodular regenerative hyperplasia. Because of the poor prognosis, patients taking purine analogues should be monitored regularly to search for inaugural signs such as an elevation of serum alkaline phosphatase or low platelet counts (which may not necessarily reach thrombopenia). The risk of methotrexate-induced fibrosis is exceptional in inflammatory bowel disease. Patients should be monitored with non-invasive tests to recognize the development of fibrosis. Finally, because of the risk of viral reactivation, patients should be screened for hepatitis B virus surface antigen before introducing infliximab; chronic carriers should be given preventive treatment with nucleoside or nucleotide analogues.

Sokol H, Seksik P, Furet JP, Firmesse O, Nion-Larmurier I, Beaugerie L, Cosnes J, Corthier G, Marteau P, Doré J. · UEPSD, INRA, Jouy-en-Josas, France. · Inflamm Bowel Dis. · Pubmed #19235886 No free full text.

Abstract: BACKGROUND: The intestinal microbiota is suspected to play a role in colitis and particularly in inflammatory bowel disease (IBD) pathogenesis. The aim was to compare the fecal microbiota composition of patients with colitis to that of healthy subjects (HS). METHODS: fecal samples from 22 active Crohn's disease (A-CD) patients, 10 CD patients in remission (R-CD), 13 active ulcerative colitis (A-UC) patients, 4 UC patients in remission (R-UC), 8 infectious colitis (IC) patients, and 27 HS were analyzed by quantitative real-time polymerase chain reaction (PCR) targeting the 16S rRNA gene. Bacterial counts were transformed to logarithms (Log(10) CFU) for statistical analysis. RESULTS: Bacteria of the phylum Firmicutes (Clostridium leptum and Clostridium coccoides groups) were less represented in A-IBD patients (9.7; P = 0.004) and IC (9.4; P = 0.02), compared to HS (10.8). Faecalibacterium prausnitzii species (a major representative of the C. leptum group) had lower counts in A-IBD and IC patients compared to HS (8.8 and 8.3 versus 10.4; P = 0.0004 and P = 0.003). The Firmicutes/Bacteroidetes ratio was lower in A-IBD (1.3; P = 0.0001) and IC patients (0.4; P = 0.002). Compared to HS, Bifidobacteria were less represented in A-IBD and IC (7.9 and 7.7 versus 9.2; P = 0.001 and P = 0.01). CONCLUSIONS: The fecal microbiota of patients with IBD differs from that of HS. The phylum Firmicutes and particularly the species F. prausnitzii, are underrepresented in A-IBD patients as well as in IC patients. These bacteria could be crucial to gut homeostasis since lower counts of F. prausnitzii are consistently associated with a reduced protection of the gut mucosa.

Branche J, Cortot A, Bourreille A, Coffin B, de Vos M, de Saussure P, Seksik P, Marteau P, Lemann M, Colombel JF. · Service des Maladies de l'Appareil Digestif et de la Nutrition, Hôpital Huriez, CHU Lille, Lille, France. · Inflamm Bowel Dis. · Pubmed #19137604 No free full text.

Abstract: BACKGROUND: Cyclosporine is considered a safe and effective treatment of severe steroid-refractory ulcerative colitis (UC). However, few data are available concerning its safety profile in pregnant women. We report here the experience of 5 GETAID centers. METHODS: In a retrospective study data on patients with severe UC treated with cyclosporine during pregnancy were extracted from medical records of consecutive patients treated between 2001 and 2007. RESULTS: Eight patients (median age 30.5 years old) were identified. At the time of flare-up the median duration of pregnancy was 11.5 weeks of gestation (range 4-25). Seven patients had pancolitis. All patients had more than 3 commonly used clinical and biological severity criteria. Three patients had severe endoscopic lesions and 5 patients had not. All patients received intravenous corticosteroids for at least 7 days before introduction of cyclosporine. Two patients received azathioprine during treatment with cyclosporine. No severe infections or other complications due to treatment were observed. Treatment was effective in 7/8 patients. One patient received infliximab due to cyclosporine therapy failure with a good outcome. No colectomy was performed during pregnancy. Seven pregnancies were conducted to term, but 1 in utero death occurred due to maternal absence of S-protein. Two newborns were premature, including 1 case of hypotrophy. No malformations were observed. CONCLUSIONS: In our experience, treatment with cyclosporine for steroid-refractory UC during pregnancy can be considered safe and effective.

Cacheux W, Seksik P, Lemann M, Marteau P, Nion-Larmurier I, Afchain P, Daniel F, Beaugerie L, Cosnes J. · Department of Gastroenterology, Assistance Publique des Hôpitaux de Paris (AP-HP), Saint-Antoine Hospital, Paris, France. · Am J Gastroenterol. · Pubmed #18047542 No free full text.

Abstract: OBJECTIVES: Cyclosporine is an effective rescue therapy in steroid-refractory ulcerative colitis (UC) and may avoid immediate colectomy. However, the individual's response to cyclosporine is poorly predictable. The aim of this study was to identify predictive factors of the response to cyclosporine in steroid-refractory UC. METHODS: One hundred thirty-five patients with steroid-refractory UC, admitted consecutively between 1992 and 2004, were included. Data were collected on the first day of the cyclosporine therapy. Colonoscopy was performed within 2 days preceding or following the cyclosporine treatment in 118 patients for assessing the presence of severe endoscopic lesions. RESULTS: The actuarial rate of colectomy was 0.45 at 6 months. Cox analysis in the whole population selected three predictive criteria of colectomy: body temperature >37.5 degrees C (adjusted hazard ratio = 1.94, 95% confidence interval 1.51-2.49), heart rate >90 bpm (1.86, 1.45-2.38), and C-reactive protein (CRP) >45 mg/L (1.70, 1.34-2.16). In the 118 patients who underwent colonoscopy, the presence of severe endoscopic lesions was an independent predictive factor of colectomy (2.38, 1.80-3.14). Colonoscopy was decisive and changed the therapeutic decision in patients with one or two criteria: 71% of the patients with severe endoscopic lesions were colectomized versus 17% of the patients without severe endoscopic lesions (P < 0.001). Finally, the clinical, biological, and endoscopic criteria allowed the classification of the patients into two different groups (80%vs 20% colectomy at 6 months). CONCLUSION: In patients with steroid-refractory UC, the combination of simple criteria is useful to predict the response to cyclosporine. Colonoscopy is crucial in patients with intermediate clinical and biological severity.

Daniel F, Loriot MA, Seksik P, Cosnes J, Gornet JM, Lémann M, Fein F, Vernier-Massouille G, De Vos M, Boureille A, Treton X, Flourié B, Roblin X, Louis E, Zerbib F, Beaune P, Marteau P. · Department of Gastroenterology, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France. · Inflamm Bowel Dis. · Pubmed #17206635 links to  free full text

Abstract: BACKGROUND: Cyclosporine A (CsA) is inconstantly effective in inducing remission in acute attacks of ulcerative colitis (UC) not responding to steroids. This study aimed to establish whether multidrug resistance gene (MDR)1 polymorphisms would be associated with CsA failure. PATIENTS AND METHODS: The distribution of the different genotypes of single nucleotide polymorphisms (SNP) G2677T/A and C3435T of MDR1 exons 21 and 26, respectively, was studied in 154 patients (mean age, 44 yr) who had received CsA to treat severe attacks of steroid resistant UC in 11 centers in France and Belgium. Patients were classified as CsA failure (n = 50) when they needed colectomy within 30 days after CsA initiation. The SNPs were detected by use of a 5' nuclease allelic discrimination assay. RESULTS: There was a significant association between the G2677T/A polymorphism distribution (exon 21) and the risk for CsA failure (P = 0.0001). The TT genotype of exon 21 was significantly associated with the risk compared with the two other genotypes (odds ratio, 3.77; 95% confidence interval, 1.42-9.97, P = 0.007). There was no significant association between the genotype C3435T distribution (exon 26) and the risk of CsA failure (P = 0.23). CONCLUSION: The TT genotype of exon 21 MDR1 polymorphisms is associated with a higher risk of CsA failure in patients with steroid resistant UC. Further studies should be performed to establish whether other treatments could be more efficient to avoid surgery in this subset of patients.

Sokol H, Lepage P, Seksik P, Doré J, Marteau P. · INRA, UEPSD, CR de Jouy-en-Josas, 78352 Jouy-en-Josas, France. · J Clin Microbiol. · Pubmed #16954244 links to  free full text

Abstract: Previous studies of the endogenous microbiota in patients with ulcerative colitis (UC) have not taken bacterial activity into account, yet bacteria with high transcriptional activity might have a more important pathophysiological role than inactive bacteria. We therefore analyzed the biodiversity of active bacteria in the fecal microbiota of UC patients, in comparison with that of healthy subjects. Feces were collected from nine patients with active UC and from nine healthy controls. Total DNA and RNA were extracted, and 16S ribosomal DNA and RNA were amplified by PCR and reverse transcription-PCR, respectively. Amplification products were compared by means of temporal temperature gradient gel electrophoresis (TTGE). Bands of interest were excised, sequenced, and identified by comparison with the GenBank database (NCBI). The dominant-species diversity based on RNA-derived TTGE profiles was significantly lower for UC patients than for healthy controls (P = 0.01). The mean similarity index between the "present" and "active" microbiota was 74% +/- 18% for UC patients. Comparison of the individual "active" microbiota identified a band that was present for eight UC patients and only two controls (89% versus 22%; P = 0.008). The band was sequenced for 6 patients and always corresponded to Escherichia coli. The biodiversity of active bacteria in the dominant fecal microbiota of patients with UC is lower than that of healthy subjects. E. coli is more represented in the active microbiota of UC patients. The possible pathophysiological role of this difference remains to be determined.

Sokol H, Seksik P, Rigottier-Gois L, Lay C, Lepage P, Podglajen I, Marteau P, Doré J. · Unité d'Ecologie et Physiologie du Système Digestif, INRA Research Center, Jouy-En-Josas, France. · Inflamm Bowel Dis. · Pubmed #16432374 links to  free full text

Abstract: BACKGROUND: Abnormalities have been described in the fecal microbiota of patients with IBD, but it is not known whether they are specific for inflammatory bowel disease (IBD) or to some extent common to other forms of colitis. The aim of this study was to compare the bacterial composition of the dominant fecal microbiota in patients with Crohn's disease (CD), ulcerative colitis (UC), infectious colitis (IC), and in healthy subjects (HS). METHODS: Fluorescent in situ hybridization adapted to flow cytometry was used to analyze the bacterial composition of fecal samples from 13 patients with active CD, 13 patients with active UC, 5 patients with IC, and 13 HS. We used 6 group-specific probes targeting 16S rRNA and spanning the main phylogenetic groups of the fecal microbiota. RESULTS: A significantly higher proportion of the total fecal bacteria were recognized by the 6 probes in HS (86.6%+/-12.7) and in IC (84.0%+/-11.7) than in patients with IBD (70.9%+/-15 in CD and 60.1%+/-25.7 in UC). The Clostridium coccoides group was reduced in UC (20.0%+/-13.3 versus 42.0%+/-12.0 in HS; P<.001), whereas the C leptum group was reduced in CD (13.1%+/-11.9 versus 25.2%+/-14.2 in HS; P=.002). The Bacteroides group was more abundant in IC (36.4%+/-22.9) than in the other 3 groups (13.8%+/-11.8 in CD, 11.7%+/-11.7 in UC, 12.1%+/-7.0 in HS; P<.001 for all 3 comparisons). CONCLUSIONS: In IBD the dominant fecal microbiota comprises unusual bacterial species. Moreover, CD and UC fecal microbiota harbor specific discrepancies and differ from that of IC and healthy subjects.

Lepage P, Seksik P, Sutren M, de la Cochetière MF, Jian R, Marteau P, Doré J. · National Institute for Agromonic Research, Digestive Tract Ecology and Physiology Unit, Research Center, Jouy en Josas, France. · Inflamm Bowel Dis. · Pubmed #15867587 No free full text.

Abstract: BACKGROUND: The mucosa-associated microbiota, being very close to the inflammatory process associated with inflammatory bowel disease (IBD), may have a pathogenic role. We used a culture-independent method to analyze the mucosa-associated microbiota in IBD patients at various points of the distal digestive tract. METHODS: Thirty-five patients (20 with Crohn's disease, 11 with ulcerative colitis, and 4 controls) underwent colonoscopy. Biopsies (n = 126) were taken from 4 sites: the ileum, right colon, left colon, and rectum. Fecal samples were also obtained from 7 individuals. Temporal temperature gradient gel electrophoresis (TTGE) of 16S rDNA was used to evaluate dominant species diversity. TTGE profiles were compared using software that measures the degree of similarity. RESULTS: In a given individual, the overall similarity percentage between the 4 segments of the distal digestive tract was 94.7 +/- 4.0%, regardless of clinical status. The average similarity of all profiles for a given segment was 59.3 +/- 18.3% in the overall population. Dendrogram analysis showed that TTGE profiles did not cluster with clinical status. Differences were observed between the dominant fecal microbiota and the mucosa-associated microbiota of all 4 sites, with similarity percentages less than 92%. CONCLUSIONS: These results confirm that the dominant species differ between the mucosa-associated and fecal microbiota. They also show that, in a given individual, the microbiota is relatively stable along the distal digestive tract, showing a slight evolution in dominant species diversity from the ileum to the rectum, in both healthy subjects and patients with IBD.

Lemann M, Beaugerie L, Bouhnik Y, Flourié B, Reimund JM, Seksik P, Marteau P. · Service de gastroentérologie, Hôpital Saint Louis, 75010 Paris. · Gastroenterol Clin Biol. · Pubmed #15672574 No free full text.

This publication has no abstract.

Marteau P, Beaugerie L, Bouhnik Y, Flourié B, Gambiez L, Reimund JM, Seksik P. · Service d'hépato-gastroentérologie, Hôpital Européen Georges Pompidou, 75015 Paris. · Gastroenterol Clin Biol. · Pubmed #15672567 No free full text.

This publication has no abstract.

Godeberge P, Desreumaux P, Slim K, Dupas JL, Marteau P, Beaugerie L, Bouhnik Y, Flourié B, Gambiez L, Reimund JM, Seksik P. · Département médico-chirurgical de pathologie digestive, Institut Mutualiste Montsouris, 75014 Paris. · Gastroenterol Clin Biol. · Pubmed #15672565 No free full text.

This publication has no abstract.

Daniel F, Seksik P, Cacheux W, Jian R, Marteau P. · Département d'Hepato-Gastroentŕologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. · Inflamm Bowel Dis. · Pubmed #15290921 No free full text.

Abstract: Derivatives of 5-aminosalicylic acid (5-ASA) used for the treatment of inflammatory bowel disease may induce acute pancreatitis of immunoallergic origin. 4-aminosalicylic acid (4-ASA) differs from its 5-ASA counterpart by the position of the NH2 group and has shown efficacy in ulcerative colitis. The risk of cross intolerance reaction between 5-ASA and 4-ASA has currently never been evaluated. We report three cases of 5-ASA-induced pancreatitis, with no recurrence of pancreatitis during subsequent treatment with 4-ASA enemas. We conclude that 4-ASA enemas are a safe and well-tolerated therapeutic alternative whenever 5-ASA-induced pancreatitis occurs.

Marteau P, Seksik P. · Service d'Hépato-Gastroentérologie, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908 Paris. · Gastroenterol Clin Biol. · Pubmed #11787388 No free full text.

This publication has no abstract.