What are the recommended first-line treatments for proctitis caused by inflammatory bowel disease?

For proctitis caused by inflammatory bowel disease, the recommended first-line treatment to induce remission in people with a mild-to-moderate first presentation or inflammatory exacerbation is a topical aminosalicylate. This is the preferred initial therapy. If remission is not achieved within 4 weeks, an oral aminosalicylate may be added. If further treatment is needed, a time-limited course of a topical or oral corticosteroid can be considered. For people who decline topical aminosalicylates, an oral aminosalicylate alone can be offered, although it is less effective than topical treatment. For those who cannot tolerate aminosalicylates, a time-limited course of topical or oral corticosteroids is recommended.