Konservative standardtherapie der colitis ulcerosa

Clinical trials have allowed the evolution of evidence-based medical standard therapy for ulcerative colitis, both for induction and maintenance of remission in disease manifestations of different severity. Several preparations - in terms of formulation and application route - of 5-aminosalicylic acid constitute the first-line therapy, while glucocorticoids are used in cases of insufficient response to 5-aminosalicylic acid and for severe disease activity. Immunomodulators are administered in chronically active colitis and in fulminant disease. Azathioprine and 6-mercaptopurine have proven to induce and to maintain remission, and they are of particular usefulness after treatment of glucocorticoid-refractory ulcerative colitis with ciclosporine. The advantages and risks of the standard medical therapy and the surgical option of restorative protocolectomy with ileoanal anastomosis have to be considered.