Medical Treatment of Ulcerative Colitis: does traditional therapy still have a role?

Ulcerative colitis (UC) is a chronic inflammatory disease which involves the colonic mucosa continuously starting from the rectum and progressively involving the entire colon. Its etiology is still unknown, although numerous studies have clarified the inflammatory mechanisms involved in the pathogenesis, allowing the development of new targeted drugs. Correct medical treatment requires the evaluation of disease extension, activity and behavior [1]. The Montreal classification allows extent to be defined into three subgroups: proctitis (when the inflammation is limited to the rectum), left-sided colitis (distal to the splenic flexure), and extensive or pancolitis (proximal to the splenic flexure) [2]. Drug formulation is chosen based on the disease extent: suppositories for proctitis, enemas for left-sided colitis and tablets for extensive colitis. Furthermore, patients with extensive colitis have a higher risk of colectomy or of developing colorectal...