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The trends in the incidence of inflammatory bowel disease (IBD) are examined over a period of 12 year from 1988 to 1999 in areas of Northern France. The incidence of Crohn's disease increased by 23 percent and the incidence of ulcerative colitis (UC) declined by 17 percent during the 12 years.

Inflammatory bowel diseases (including ulcerative colitis and Crohn's disease) are a group of conditions in which painful inflammation of the large intestine, particularly the colon, is accompanied by diarrhea, bleeding, and other symptoms. It has been claimed that diets rich in fish lipids (fats) are beneficial in the treatment of a number of diseases, including inflammatory bowel disease. To determine whether the constituent fatty acids in fish oils are incorporated into the mucosa (lining) of the colon and evaluate their effect on the biosynthesis of inflammatory mediators, a study was carried out in which 20 patients with ulcerative colitis or Crohn's disease were given oral supplements of either fish oil or olive oil for 12 weeks. The patients receiving fish oil supplements showed increased levels of eicosapentanoic and docosahexanoic acid (the major fatty acids in fish oil) after three weeks of treatment and for the duration of the study. No changes were seen in the levels of these compounds in the patients receiving olive oil. In addition, colonic mucosal levels of the inflammatory mediators arachidonic acid, prostaglandin E2, thromboxane B2 and 6-keto prostaglandin F1-alpha were suppressed only in the group receiving the fish oil supplement. Further studies will need to be done to determine the time course of this effect (values had plateaued by three weeks, the earliest time point sampled), as well as whether varied dosage schedules have any effect on the incorporation of fatty acids into the intestinal mucosa or the selective production of inflammatory mediators. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sulfasalazine is a drug that is chemically related to aspirin and used in the treatment of ulcerative colitis. Oral sulfasalazine is broken down into two metabolites in the lower digestive tract. Of these, 5-aminosalicylic acid (5-ASA) is the therapeutically active product. Since the discovery that 5-ASA (which by itself is not orally active) is the active molecule, a variety of drug delivery strategies have been developed to chemically link 5-ASA with other molecules, and coated capsules and slow-release formulations have been designed to get the 5-ASA into the large intestine where it acts on the luminal side of the colon (inside the digestive tract). Intestinal absorption of 5-ASA occurs, but increased blood levels of the drug do not confer any additional therapeutic benefit and may, in fact, be toxic to the kidney. Fourteen patients with ulcerative colitis in remission took part in a study to evaluate the ability of several different formulations of 5-ASA-containing preparations to increase colonic concentrations of the drug. Each subject received a novel formulation (olsalazine; disodium azodisalicylate), both as coated tablets and gel capsules, and three other commercially available mesalazine formulations (Asacol, Pentasa, or Salofalk). Colonic and blood levels, as well as urinary excretion, of 5-ASA were determined after five days of each treatment. Olsalazine treatment doubled the colonic concentration of 5-ASA compared with Pentasa and Salofalk but not with Asacol; blood levels and urinary excretion of 5-ASA were decreased compared with the mesalazines. This indicates that olsalazine is one of the best vehicles for delivering 5-ASA to its site of action, while reducing the systemic concentrations of the drug that may be harmful to the kidney. (Consumer Summary produced by Reliance Medical Information, Inc.)