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Ulcerative colitis is a disease that causes inflammation and ulcers in the lining of the rectum. The disease can be debilitating and sometimes lead to life-threatening complications. Treatment of ulcerative colitis includes pharmacological and non-pharmacological treatment.
1. Drug treatment
Ulcerative colitis is a chronic inflammatory and ulcerative disease of the colonic mucosa, most characterized by bloody diarrhea. In addition, patients may have extra-intestinal symptoms, especially arthritis. Symptoms of ulcerative colitis usually develop gradually over time. Ulcerative colitis can be debilitating and sometimes lead to life-threatening complications. Long-term risk of ulcerative colitis and colon cancer. Medications for ulcerative colitis can significantly reduce the signs and symptoms of the disease. There are several medications for ulcerative colitis, including:
5-aminosalicylic acid (5-ASA): Balsalazide, mesalamine, olsalazine, and sulfasalazine are the main drugs used to treat ulcerative colitis. They come in the form of pills and suppositories. Tell your doctor if you are allergic to sulfa before taking one of these medications so they can consider prescribing the right medication. Corticosteroids: Corticosteroids may be used if 5-ASA doesn't work or if ulcerative colitis gets worse. These medications sometimes have side effects and long-term complications, so doctors often prescribe them for short periods of time to help remission, and then may switch to 5-ASA drugs to suppress symptoms. for a long time. Immunosuppressants: If corticosteroids or 5-ASA drugs don't work, your doctor may prescribe immunosuppressive drugs such as 6-mercaptopurine, azathioprine, cyclosporine, and tacrolimus. Biologic therapies: This class of drugs includes adalimumab (Humira), plus adalimumab-atto (Amjevita) and adalimumab-adbm (Cyltezo), certolizumab pegol (Cimzia), golimumab (Simponi, Simponi Aria), infliximab (Remicade), infliximab-abda (Renflexis), infliximab-axxq (Avsola), infliximab-dyyb (Inflectra), biosim analogues of Remicade, IX), ustekinumab (Stelara), and vedolizumab (Entyvio). Janus kinase inhibitors (JAK inhibitors): These are quick-acting oral medications that help ulcerative colitis go into remission. Tofacitinib was the first JAK inhibitor approved by the FDA for the treatment of ulcerative colitis. Sphingosine 1-phosphate (S1P) receptor modulator: Ozanimod was the first oral sphingosine 1-phosphate (S1P) receptor modulator approved for patients with moderate to severe active ulcerative colitis .
2. Non-drug treatment
2.1 Change in diet Although foods are unlikely to play a role in causing ulcerative colitis, certain foods can worsen symptoms when the disease is active. Your doctor may recommend dietary changes, depending on your symptoms. They can also recommend vitamins or nutritional supplements. Here are some dietary suggestions to help manage ulcerative colitis:
Limit dairy products: Many people with ulcerative colitis find problems such as diarrhea, pain, and inflammation. Abdominal and bloating are improved by limiting or eliminating dairy products. Some patients are lactose intolerant - that is, the body cannot digest the milk sugar (lactose) in dairy foods. In that case the patient can use an enzyme product such as Lactaid to improve symptoms. Eat small meals: You may feel better eating five or six small meals a day instead of two or three large meals. Drink plenty of fluids: Try to drink plenty of fluids daily. Water is best. Alcohol and caffeinated beverages stimulate the intestines and can make diarrhea symptoms worse, while carbonated drinks often produce gas that causes bloating. 2.2 Surgery for ulcerative colitis Some patients will have surgery to remove part or all of the colon. Your doctor may recommend surgery if medications don't work, symptoms get worse, or ulcerative colitis leads to serious complications. When performing a total colectomy, the surgeon usually creates a hole in the abdominal wall and attaches a bag to let waste out.
A newer surgical technique, called an ileostomy anastomosis (IPAA) does not create a permanent opening. Instead, the surgeon will remove the colon and rectum, and the small intestine will be used to form an internal pouch or reservoir that acts as a new rectum. This pouch will be attached to the anus. Besides, there are still a number of other surgical methods for the doctor to choose depending on the patient's condition and needs. All surgeries have some risks and complications. Therefore, you should carefully ask your doctor about the possible risks before deciding to have surgery to treat ulcerative colitis.
2.3 Complementary therapy You can consider these approaches in addition to what your doctor prescribes. Some of the therapies you can try include:
Psychotherapy: Stress and anxiety are the cause for many people with ulcerative colitis, so it's not surprising whether Mindfulness techniques can help. These techniques help foster a healthy connection between mind and body and between you and the outside world. In some cases, this therapy will encourage behavioral changes in everyday life. They can reduce anxiety and depression associated with ulcerative colitis and improve quality of life. In addition, there is some evidence that yoga, meditation, and hypnotherapy may help reduce some symptoms of ulcerative colitis. Some techniques, such as cognitive behavioral therapy, have been so successful that they are slowly becoming part of the mainstream treatment for irritable bowel syndrome. Vitamins and supplements: Many people with ulcerative colitis may not get enough of certain vitamins or minerals from foods. In these cases, your doctor may suggest you take some supplements. However, some of these substances may not be safe, especially if you have ulcerative colitis and are taking other medications. Therefore, you need to consult your doctor before using supporting products. Some supplements that can help treat ulcerative colitis include: Fish oil: omega-3 fatty acids found in fish, walnuts, flaxseeds and vegetable oils are very good for health. They reduce inflammation and help protect the heart. Some people with ulcerative colitis take omega-3 supplements in the form of fish oil capsules to reduce intestinal inflammation. Research to date has not determined whether taking fish oil is effective for patients with ulcerative colitis. Many fish oils can be bad for you and can be dangerous if you take them with anticoagulants like warfarin (Coumadin). Turmeric: This is a spice commonly used in cooking in Indian and South Asian countries. There is an ingredient in turmeric called curcumin that may help reduce inflammation in some people. Some small studies suggest it may help reduce flare-ups of ulcerative colitis when taken in capsule form, but scientists need more studies to definitively determine curcumin's benefits. Curcumin can also cause side effects such as bloating, nausea, and diarrhea. It also thins the blood and has not been tested for safety in pregnant women. Probiotics: These are “good” bacteria found in many foods that help replenish the balance of bacteria in the gut. Some studies suggest they may help reduce flare-ups of ulcerative colitis. 2.4 Cancer Screening You will need to get screened for colon cancer more often because the risk of cancer increases with ulcerative colitis. The recommended schedule will depend on the location and duration of the disease. During treatment, you need to see a doctor immediately if you notice some of the following signs:
Abdominal pain Bloody stools Persistent diarrhea that does not respond to over-the-counter medications Diarrhea that makes you sleepless Fever unknown causes lasting more than a day or two. In general, ulcerative colitis is not usually fatal, but it is a serious condition. In some cases, the disease can cause life-threatening complications. Therefore, patients with symptoms of ulcerative colitis should go to the doctor for timely detection and treatment. Patients must adhere to the treatment prescribed by their doctor, change their diet, reduce stress, maintain a healthy lifestyle and have regular cancer screenings.
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