S U M M A R YBackground: Rectal foam enemas provide for drug delivery to the distal colon for treatment of left sided ulcerative colitis. However, currently available formulations contain chlorofluorocarbons which are due to be phased out in the near future. The objective of this study was therefore to determine the degree of dispersion of a newly developed nonchlorofluorocarbon rectal foam preparation in ulcerative colitis patients. Methods:This was an open label non-controlled study of a single administration of a mesalazine foam enema (two actuations containing 2 g of mesalazine in approximately 120 mL foam) in 10 patients with quiescent ulcerative colitis. Spreading of the 99mTclabelled foam enema was assessed over a 4-h period by the non-invasive technique of gamma scintigraphy. Results: All patients retained the enema for the full 4-h imaging period. In nine out of the 10 patients, the enema was observed to spread as far as the descending colon and on average 2 3 % of the dose was present in the descending colon at 4 h post-dose. Conclusions : The extent of spreading observed in the study supports the use of the formulation in the treatment of left sided ulcerative colitis.

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LINKED CONTENTThis article is linked to Lee et al and Lee and Kim papers. To view these articles, visit https://doi.org/10.1111/apt.15741 and https://doi.org/10.1111/apt.15992

Video endoscopy is an important modality for the diagnosis and treatment of various gastrointestinal diseases. Most endoscopic procedures are performed as outpatient basis, sometimes requiring sedation and deeper levels of anesthesia. Moreover, advances in endoscopic techniques have allowed invasion into the third space and the performance of technically difficult procedures that require the utmost precision. Hence, formulating strategies for the discharge of patients requiring endoscopy is clinically and legally challenging. In this review, we have discussed the various criteria and scores for the discharge of patients who have undergone endoscopic procedures with and without anesthesia.