Allergy to topical corticosteroids in inflammatory bowel disease

Abstract

A 57 year old Caucasian man presented with an eight week history of loose bowel motions 10 times daily, with blood, slime, and mucus. Sigmoidoscopy showed an abnormal vascular pattern and a granular mucosa. Rectal biopsy was reported histologically to show inflammatory bowel disease, and treatment was initiated with oral Asacol (mesalazine) 800 mg three times daily and Predfoam (prednisolone metasulphobenzoate sodium) enema twice daily. This treatment was continued over a period of about eight weeks, initially with some improvement but latterly relapsing to the pretreatment state. Fibreoptic colonoscopy was then performed, revealing inflammatory changes up to the distal sigmoid colon. Biopsies were suggestive of Crohn’s disease. Treatment was continued for a further three months without improvement. The patient decided on his own initiative to stop …