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소화관질환에 대한 Steroid제의 이용

CORTICOSTEROID IN THE TREATMENT OF DISEASES OF THE ALIMENTARY TRCAT

한국의과학 1970년 2권 4호 p.13 ~ 17
최흥재,
소속 상세정보
최흥재 (  ) - 연세대학교 의과대학 내과학교실

Abstract


The use of corticosteroid in the treatment of diseases of the alimentary tract is briefly reviewed.
Steroids are effective on lye burns in the esophagus in preventing the development of a fibroblastic type of structure which otherwise might occur. Although the esophageal involvement of scleroderma does not favorably respond to the use of steroids, there have been sporadic reports in the literature which describe occasional improvement.
Corticosteroids improve the function of the small intestine in some cases of mal-absorption syndrome. In non-tropical sprue it would probably be wise to reserve this treatment as a temporary measure for acutely ill patients and use it for longer periods only in severe and intractable cases that have failed to respond to gluten-free diet and other treatments. Steroids may- improve absorption and induce remission in Whipple´s diseases, and this may be due to the reduction of secondary inflammation in the lymph nodes resulting from , the improvement of the obstructed lymph flow rather than to the alteration of the basic defect.
In ulcerative colitis, the addition of steroids to the standard therapy may not only induce a rapid clinical remission in many patients but also reserve a critical, life-threatening illness and thus permit adequate preparation of the patient for colectomy. The rationale for the use of steroids is based on the reduction of vascular and tissue responses to inflammation and suppression of the accompanying
toxic reaction and perhaps a favorable influence on the hypersensitivity mechanism or inhibition of the production of bacterial endotoxin within the colon. In regional enteritis, the effectiveness of steroids is not so great, dramatic or predictable as in ulcerative colitis.
The primarily palliative rather than curative role of corticosteroids in addition to the potential complications of steroid therapy emphasizes the importance of a clear and valid indication for their use.

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