Ecabet sodium (ES), a 12-sulfodehydroabietic acid monosodium salt derived from an ingredient in pine resin, has been shown to topically enhance several gastric mucosal defensive factors.¹ ES is widely used for the treatment of gastritis and gastric ulcer in Japan. A recent open label study demonstrated that ES also has therapeutic effects in active ulcerative colitis (UC).² In that study, the authors demonstrated that six of seven UC patients with proctosigmoiditis achieved complete remission by treatment with ES enema. However, successive clinical trials of the efficacy of ES enema in UC patients have not been reported. Here we demonstrate the efficacy of ES enema in steroid resistant or steroid dependent UC patients. …