Clinical and endoscopic response to rectal ozone therapy in active idiopathic ulcerative colitis: preliminary experience in a Cuban center

Abstract

Introduction: Idiopathic ulcerative colitis (IUC) is a chronic inflammatory disease whose conventional management may be insufficient or generate adverse effects. Rectal ozone therapy emerges as a therapeutic alternative with anti-inflammatory, immunomodulatory, and regenerative properties.

Objective: To evaluate the clinical and endoscopic response, as well as the safety, of treatment with rectal ozone in patients with mild to moderate active IUC.

Methods: A quasi-experimental before-after study with a control group included 30 patients divided into two groups: 15 received rectal ozone therapy (10 sessions of 20 mg/L ozone in 40 ml of oxygen, twice a week for 5 weeks) and 15 received conventional treatment (mesalazine and/or corticosteroids). Response was assessed using the Truelove-Witts index and endoscopic criteria at 8 weeks’ post-treatment.

Results: Male gender (60%) and the 50-59 age group (53.3%) predominated. Proctosigmoiditis was the most frequent extent (50%). Good clinical response was 43.3% in the ozone group versus 23.3% in the control group. No adverse reactions were reported.

Conclusions: Rectal ozone therapy showed a favorable trend towards clinical and endoscopic improvement, with an adequate safety profile in patients with mild to moderate active IUC. These findings support the need for randomized controlled trials to confirm its efficacy.