Topical Budesonide for Treating Giant Rectal Pseudopolyposis

Abstract

Pseudopolyps are a frequent finding in the course of inflammatory bowel disease. They are non-neoplastic lesions resulting from a regenerative and healing process that leaves inflamed colonic mucosa in polypoid configuration. Data about their management is lacking. “Giant” pseudopolyps can be mistaken for adenocarcinomas and, as they rarely regress with medical management alone, a surgical resection is often required. A case of giant pseudopolyposis treated non-surgically, in a patient with concomitant ulcerative colitis and chronic hepatitis B, is reported, representing a co-morbidity complicating an eventual conservative treatment. The clinical implementation of topical budesonide was originally tested, resulting in clinical, endoscopic and histological remission. Budesonide seems a promising therapy for IBD, particularly when a comorbidity with viral hepatitis exist.