The results of our study further contribute to the assessment of risk factors for complications related to ERCP/ES. It is crucial to identify high risk patients to reduce complications of the procedures.

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SUMMARY BackgroundThe impact of pregnancy on the course of IBD is still controversial.

SUMMARYAim: To evaluate efficacy and safety of oral beclometasone dipropionate (BDP) when added to 5-ASA in the treatment of patients with active ulcerative colitis. Methods: In a 4-week, placebo-controlled, double-blind study, patients with extensive or left-sided mild to moderate active ulcerative colitis were randomized to receive oral 5-ASA (3.2 g ⁄ day) plus BDP (5 mg ⁄ day) or placebo. Clinical, endoscopic and histologic features, and haematochemical parameters were recorded at baseline and at the end of the study. Results: One hundred and nineteen patients were enrolled and randomly treated with BDP plus 5-ASA (n ¼ 58) or placebo plus 5-ASA (n ¼ 61). Both treatment groups showed a statistically significant decrease of disease activity index (DAI) and histology score at the end of treatment (P ¼ 0.001, each). DAI score was lower in the BDP group than in the placebo group (P ¼ 0.014), with more patients in clinical remission in the BDP group (58.6% vs. 34.4%, P ¼ 0.008). Serum cortisol levels significantly decreased in BDP group vs. baseline (P ¼ 0.002), but without signs of pituitary-adrenal function depletion. A low incidence of adverse events was observed in both groups. Conclusions: Oral BDP in combination with oral 5-ASA is significantly more effective than 5-ASA alone in the treatment of patients with extensive or left-sided active ulcerative colitis.

Proximal extension of ulcerative proctitis is frequent and may occur even late after the original diagnosis. However, the risk of extension beyond the splenic flexure appears to be quite low. Smoking seems to be a protective factor against proximal extension, whereas refractoriness is a risk factor for proximal extension of the disease.