Published online Apr 16, 2022. doi: 10.12998/wjcc.v10.i11.3573
Peer-review started: November 8, 2021
First decision: December 27, 2021
Revised: January 8, 2022
Accepted: February 27, 2022
Article in press: February 27, 2022
Published online: April 16, 2022
Processing time: 150 Days and 23.2 Hours
Ulcerative colitis (UC) is a chronic autoimmune disease characterized by relapsing-remitting abdominal pain, diarrhea, mucopurulent discharge and rectal bleeding. To date, the etiology of the disease remains unknown; therefore, medical therapy is not yet available. Left-sided UC is mainly treated with oral and topical mesalazine. However, due to its modest clinical effect, endoscopic mucosal remission is not achieved in all patients.
A 44-year-old man presented to Longhua Hospital with a history of left-sided UC for more than 6 years and slight bloody diarrhea over time. Endoscopy suggested hyperemia, edema, and erosive mucosa involving the rectum and sigmoid colon. The Traditional Chinese medicine Qingchang decoction (QCD) enema treatment was initiated once a day combined with a previous standard dose of mesalazine for 8 wk, and rectal bleeding ceased after 4 wk of treatment. Another QCD enema treatment was provided after symptom relapse due to drug withdrawal for nearly 6 mo. At the 2-mo follow-up, the colonoscopy results indicated mucosal healing with no erosion or ulcers.
The Chinese formula QCD retention enema represents a potential treatment for left-sided UC with predominant rectal bleeding to achieve clinical and mucosal remission.
Core Tip: We present a case of a 44-year-old man with mildly active left-sided ulcerative colitis (UC) for 6 years in whom mesalazine treatment failed but clinical and mucosal remission was achieved following Chinese formula Qingchang decoction (QCD) retention enema treatment combined with oral mesalazine. Thus, a QCD enema may be an effective treatment modality for patients with left-sided UC.