pulmicort and Peptic-Ulcer

Studies have demonstrated that budesonide is effective in the treatment of active Crohn's disease. Due to its extensive hepatic metabolism, budesonide has much lower adverse events compared to prednisolone. Consequently, the low systemic availability restricts its application to Crohn's disease of the terminal ileum and the colon. Esophageal ulceration is a rare complication of Crohn's disease. This article describes the case of a young lady who presented at the age of 16 with active Crohn's disease of the terminal ileum and the colon without dysphagia or pain in the chest. Her disease was successfully treated with prednisolone for almost two years. Because of weight gain, acne, and moon face she was switched to budesonide. A few days later she presented with intractable pain of the esophagus, dysphagia, and inability to eat. Endoscopy demonstrated aphthous ulcerations of the esophagus and the histology was compatible with Crohn's disease. After two weeks of treatment with prednisolone all symptoms resolved and at follow-up gastroscopy ulcers had disappeared.

Topics: Adolescent; Budesonide; Crohn Disease; Esophagitis; Female; Humans; Peptic Ulcer; Prednisolone; Treatment Outcome

The past 12 months have been a period of steady progress in the field of gastroenterology. Helicobacter pylori continues to dominate many areas of clinical research and the indications for eradication are increasing. A potent, topically-acting corticosteroid for Crohn's disease, and new hope and potential treatments for IBS sufferers are other developments.

Topics: Administration, Topical; Anti-Inflammatory Agents; Budesonide; Colonic Diseases, Functional; Dietary Fiber; Gastrointestinal Neoplasms; Glucocorticoids; Helicobacter Infections; Humans; Inflammatory Bowel Diseases; Peptic Ulcer; Pregnenediones; Sigmoidoscopy