3PC-001 Magistral formulation of 10% sucralfate enemas in proctitis

Background Actinic proctitis is the rectal mucosa’s inflammation after treatment with radiotherapy of different pelvic region’s tumours. The most frequent clinic includes tenesmus, defective urgency and rectal bleeding. Several studies have suggested that sucralfate enemas may improve proctitis’s symptoms by inducing a macroscopic improvement of the injured area. Purpose To evaluate the effectiveness of sucralfate enemas in proctitis. Material and methods An observational, descriptive and retrospective study was performed in patients who received enemas (October 2014 to April 2016) prepared by the pharmacy service. Variables collected: age, sex, diagnosis of prostatitis, type of cancer, symptoms, duration and dosage of sucralfate treatments in enemas and rate of bleeding episodes. Results Ten patients, diagnosed with proctitis as a side effect of radiotherapy, required the preparation of enemas (70% male; median age 80 (68–82) years). Six of them had prostate adenocarcinoma, three had rectal neoplasia and one endometrial neoplasia. The symptoms presented by proctitis were mainly rectal bleeding, iron deficiency anaemia, tenesmus and diarrhoea. The dosage was one or two enemas per day depending on the severity of the symptoms. The duration of treatment was variable: three patients used enemas only during rectal bleeding episodes (15–30 days), two patients used them for periods between 1 to 3 months, two patients for 4 to 6 months and one patient used them continuously. Two patients currently continue on active treatment. An improvement in symptoms was observed in 100% of patients with a reduction in rectal bleeding episodes. The recurrences occurred more frequently in the group of patients who used the enemas intermittently, needing to restart the treatment in a period of less than 6 months. One of the patients whose treatment duration was 6 months, had to restart after 1 year after the end of treatment. A high degree of satisfaction was observed by both the patients and the professionals who prescribed the treatment. Conclusion The magistral preparation of sucralfate enemas in 10% suspension significantly improves bleeding episodes in these patients, allowing significant symptomatic relief. Reference and/or acknowledgements McElvanna K. Sucralfate paste enema: a new method of topical treatment for haemorrhagic radiation proctitis. Colorectal Dis 2014;16:281–4. No conflict of interest.