Of all the agents employed in chronic ulcerative colitis - sedative, antispasmodic, anti-bacterial and hormonal - the last two appear to have the greatest influence on the symptoms and the clinical course of the severe forms of this disease. It is true that favourable clinical reports have appeared on many different drugs, but the reports seldom take into account the fact that ulcerative colitis is a chronic disease of unknown cause, characterized by unpredictable remissions and recurrences, and that milder attacks usually run a self-limited course regardless of therapy. In severe cases, however, therapy with corticosteroids or ACTH can often shorten the duration of attacks and decrease toxaemia, fever and diarrhoea. There is little evidence that recurrences are prevented on long-term steroid therapy.
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