Mesalazine enteric-coated tablets combined with retention enema for symptom alleviation in mild to moderate E2-type active ulcerative colitis: A retrospective comparative cohort study.

Key Takeaways for GI Nurses

• This retrospective cohort study examined combining oral mesalazine enteric-coated tablets with mesalazine retention enemas for patients with mild to moderate E2-type (left-sided) active ulcerative colitis, a common presentation seen in both inpatient and outpatient GI settings.
• Combination oral-plus-topical mesalazine therapy is an established first-line approach for left-sided UC, and nurses play a critical role in patient education on proper enema retention technique to maximize mucosal drug delivery and symptom control.
• Understanding disease extent classification (E1, E2, E3 per the Montreal Classification) helps GI nurses anticipate which patients are candidates for topical therapy and tailor counseling accordingly during clinic visits, infusion appointments, or pre-procedure assessments.
• Since the full abstract and outcome data are not yet available, nurses should treat this as an emerging evidence update and follow up with the full-text publication before incorporating specific efficacy or safety claims into patient teaching materials or care pathways.

Clinical Relevance

Left-sided ulcerative colitis (E2 by Montreal classification) presents unique therapeutic challenges because oral mesalazine alone often fails to achieve adequate mucosal concentrations in the distal colon and rectum. Combining oral enteric-coated tablets with mesalazine retention enemas addresses this gap by delivering medication directly to the affected segment, and GI nurses are frequently the ones translating this dual-therapy regimen into practical, achievable instructions for patients. Teaching correct enema administration — positioning, retention time, and timing relative to oral doses — directly affects whether patients achieve adequate drug exposure and, ultimately, symptomatic improvement.

From a care-coordination standpoint, this study reinforces the importance of nurses assessing adherence barriers specific to topical rectal therapies, including patient discomfort, embarrassment, urgency symptoms that limit retention, and the physical difficulty some patients face with self-administration. Nurses in GI clinics and infusion units are well positioned to screen for these barriers at follow-up visits and to reinforce education that supports sustained combination therapy rather than default reversion to oral-only treatment, which may be less effective for E2-type disease. Retrospective cohort data such as this also strengthen the evidence base nurses can draw on when counseling patients who are hesitant about enema use, helping normalize combination therapy as a guideline-supported strategy rather than an escalation step.

For unit operations, findings like these may inform patient education materials, discharge instructions, and standardized teaching checklists used by endoscopy and IBD nursing teams. As evidence accumulates supporting combination regimens for mild to moderate left-sided UC, nurses may also play a larger role in shared decision-making conversations, helping patients weigh the practicalities of enema therapy against the potential for faster symptom resolution and reduced need for systemic therapy escalation.

Bottom Line

While full outcome data from this study are not yet available, the research reinforces a practice-relevant principle: for mild to moderate E2-type (left-sided) ulcerative colitis, combining oral mesalazine with retention enemas is a recognized strategy for improving topical drug delivery and symptom control, and GI nurses should prioritize clear, judgment-free education on enema technique and adherence to help patients get the full benefit of this combination approach.