Medications
For severe IBD (more than six stools a day, mostly bloody) or if 5-ASAS don't help, you might do well with corticosteroids. These are given as intravenous or oral medications or as an enema.
For severe Crohn's disease, the next line of defence is powerful immunosuppressant medications, such as mercaptopurine (Purinethol), azathioprine (Imuran), methotrexate and cyclosporine (Cysporin). These drugs are often prescribed in combination with corticosteroids. The newest medication for moderate to severe Crohn's disease is a monoclonal antibody (an immune cell that specifically targets a particular disease-causing agent) called infliximab (Remicade). This drug attacks tumour necrosis factor, an inflammatory protein associated with IBD, before it can reach your intestines. The largest study of a Crohn's disease medications showed that after 54 weeks of inflxiwab therapy, patients were twice as likely to be in remission as those not using the drug, and many were able to go off corticosteroids. However, the use of infliximab in Australia and New Zealand is limited by cost as it is not subsided and must be registered.
To battle bacteria from blockages or fistulae in the small intestine, your doctor will prescribe antibiotics such as ampicillin or tetracycline. For diarrhoea, you can get relief with over-the-counter medications such as loperamide (Imodium) or a atropine sulfate (Lomotil).
PROMISING DEVELOPMENTS
Although changes in lifestyle won't IBD disappear, they can significantly improve your quality of life by helping to keep your symptoms to a minimum. Here are some good suggestions:
Drink plenty of water. The diarrhoea associated with IBD can dehydrate you, and you need to regularly replace lost fluid.
Avoid foods that may cause inflammation. Everyone's system is different, but remain alert for bad reactions. Some well-known food irritants include saturated fats, milk products, alcohol, caffeine, sugar, dried fruit, high-sugar fruits (grapes, watermelon, pineapple), wheat, oats, barley, soy,eggs, peanuts, tomatoes, beets, chocolate, pepper, lamb, lime peel, nuts, parsley, poppy seeds, rhubarb and spinach. Track what you eat and if any of these food makes you feel bad, stop eating it.
Take omega-3 fatty acids. There is ample evidence to show that fish oil and flaxseed oil can help to minimise the symptoms of IBD. Eat cold-water fish such as salmon at least three times a week. You can also use omega-3 supplements (just follow the label directions for dosage).
Eat smaller, more frequent meals. This will help to keep gas to a minimum, especially if your diet has a high fibre content.
Try to maintain a normal weight. If you're dropping too many kilo (which is likely with Crohn's disease), add high-kilojule nutrition bars and shakes to your diet.
Stop smoking. This is especially true if your have Crohn's disease. Research shows that smoking aggravates the progression of this disease. The symptoms of ulcerative colitis, on the other hand, actually seem to be improved by nicotine.
Do light exercise. In a recent small study, people with mild or inactive forms of Crohn's disease who walked for 30 minutes three times a week experienced significant improvement in their quality of life. Consult a doctor before doing more vigorous exercise.
Reduce stress. Evidence shows that stress aggravates inflammatory diseases. Try meditation or other stress-reduction techniques.
Procedures
After diagnosis, you'll need checkups with a gastroenterologist to monitor your intestinal health. The doctor may want to do one of three screening procedures on a regular basis. If you have ulcerative colitis, you may need a sigmoidoscopy, in which a thin, flexible, lighted viewing tube is passed into the rectum and through the lower third of the colon (see on later). For either ulcerative colitis or Crohn's disease, a colonscopy (see on later) may be ordered. This procedure allows the doctor to examine almost all the entire length of your colon with the aid of a flexible fibre-optic tube. If you have Crohn's disease, you may undergo regular barium meals, in which you drink a chalky substance that lines the small intestine and allows your doctor to see abnormalities on an X-ray.
If you have advanced IBD and drug therapy isn't helping you, you may need surgery. In the case of ulcerative colitis, that means possibly removing your colon, a colectomy, which will cure the disease. After this procedure, you will need to collect your facial matter either in an extrenal pouch connected to your intestine through your abdomen, called an ostomy, or in an internal pouch made of tissue from your intestines. If you have surgery for Crohn's disease, it usually means removing the part of the intestine with a blockage or abscess. This won't cure the disease, but will allow fluid and food to proceed normally through your digestive tract.
NICOTINE PATCH FOR ULCERATIVE COLITIS
It's rare that you'll hear anyone say anything good about nicotine, but if it's adminstered in the right way, it can be a godsend to ulcerative colitis patients. Although smoking can worsen Crohn's disease, just the opposite happens with ulcerative colitis: it puts patients into remission. Obviously, smoking remains a bad idea for many reasons, but there are ways other than cigarettes to get nicotine into your system.
A transdermal nicotine patch that smokers use to help them break their habit is one example. In a study published by the Mayo Clinic, 12 of 31 patients showed improvement in their mild to moderate ulcerative colitis after four weeks on the patch. If you have ulcerative colitis, talk to your doctor about giving the nicotine patch a try.
Natural methods
Certain herbs may prove helpful in relieving IBD symptoms. They are available in pill, tincture or extract form; teas made from the dried herbs can be useful as well. To calm inflammation, try marsh-mallow root. For a tea, add 30 g of flowers to a litre of boiling water, steep for a few minutes, then strain out the petals. Slippery elm may also be helpful. For a tea, slowly add warm water to 1 heaped teaspoon of dried bark; strain before sipping. To combat unfriendly bacteria in the intestine, try goldenseal. For infections, take 15 drops of extract--sold at health-food stores--every hour. To encourage normal immune function, take echinacea. In capsule form, you need to get at least 900 mg a day.
These herbs are generally safe, but don't take goldenseal if you're pregnant or echinacea if you have an autoimmune disease. Some evidence indicates that echinacea is more effective if you use it for three weeks and then abstain for one. And don't forget a daily multivitamin/mineral. With fluid leaving your body in copious amounts, you may become malnourished. A high-quality multivitamin supplement can help you combat this problem.
For severe IBD (more than six stools a day, mostly bloody) or if 5-ASAS don't help, you might do well with corticosteroids. These are given as intravenous or oral medications or as an enema.
For severe Crohn's disease, the next line of defence is powerful immunosuppressant medications, such as mercaptopurine (Purinethol), azathioprine (Imuran), methotrexate and cyclosporine (Cysporin). These drugs are often prescribed in combination with corticosteroids. The newest medication for moderate to severe Crohn's disease is a monoclonal antibody (an immune cell that specifically targets a particular disease-causing agent) called infliximab (Remicade). This drug attacks tumour necrosis factor, an inflammatory protein associated with IBD, before it can reach your intestines. The largest study of a Crohn's disease medications showed that after 54 weeks of inflxiwab therapy, patients were twice as likely to be in remission as those not using the drug, and many were able to go off corticosteroids. However, the use of infliximab in Australia and New Zealand is limited by cost as it is not subsided and must be registered.
To battle bacteria from blockages or fistulae in the small intestine, your doctor will prescribe antibiotics such as ampicillin or tetracycline. For diarrhoea, you can get relief with over-the-counter medications such as loperamide (Imodium) or a atropine sulfate (Lomotil).
PROMISING DEVELOPMENTS
- Researchers at the University of Pennsylvania Medical Center have discovered that drugs called thiazolidine-diones, which are already used by people with diabetes, can decrease the symptoms of inflammatory bowel disease in mice (especially those of ulcerative colitis) by an astounding 80%.
- Studies of a substance called hepatocyte growth factor, which is naturally produced in the liver and small intestine, have shown it can almost completely eliminate the symptoms of IBD in laboratory animals disappear, it also got rid of half of the microscopic lesions. The researchers, presenting the findings at a 1999 American College of Surgeons meeting, hope to some day try the agents in human.
- For most people, having worms, doesn't seem too desirable, but the possible may be true if you have IBD. Researchers at the University of lowa have recently had success treating people with IBD using intestinal worms called helminthic parasites. Patients swallow microscopic eggs in a glass of Gatorade. In studies to date, nearly all of the patients have gone into remission, with no side effects.
Although changes in lifestyle won't IBD disappear, they can significantly improve your quality of life by helping to keep your symptoms to a minimum. Here are some good suggestions:
Drink plenty of water. The diarrhoea associated with IBD can dehydrate you, and you need to regularly replace lost fluid.
Avoid foods that may cause inflammation. Everyone's system is different, but remain alert for bad reactions. Some well-known food irritants include saturated fats, milk products, alcohol, caffeine, sugar, dried fruit, high-sugar fruits (grapes, watermelon, pineapple), wheat, oats, barley, soy,eggs, peanuts, tomatoes, beets, chocolate, pepper, lamb, lime peel, nuts, parsley, poppy seeds, rhubarb and spinach. Track what you eat and if any of these food makes you feel bad, stop eating it.
Take omega-3 fatty acids. There is ample evidence to show that fish oil and flaxseed oil can help to minimise the symptoms of IBD. Eat cold-water fish such as salmon at least three times a week. You can also use omega-3 supplements (just follow the label directions for dosage).
Eat smaller, more frequent meals. This will help to keep gas to a minimum, especially if your diet has a high fibre content.
Try to maintain a normal weight. If you're dropping too many kilo (which is likely with Crohn's disease), add high-kilojule nutrition bars and shakes to your diet.
Stop smoking. This is especially true if your have Crohn's disease. Research shows that smoking aggravates the progression of this disease. The symptoms of ulcerative colitis, on the other hand, actually seem to be improved by nicotine.
Do light exercise. In a recent small study, people with mild or inactive forms of Crohn's disease who walked for 30 minutes three times a week experienced significant improvement in their quality of life. Consult a doctor before doing more vigorous exercise.
Reduce stress. Evidence shows that stress aggravates inflammatory diseases. Try meditation or other stress-reduction techniques.
Procedures
After diagnosis, you'll need checkups with a gastroenterologist to monitor your intestinal health. The doctor may want to do one of three screening procedures on a regular basis. If you have ulcerative colitis, you may need a sigmoidoscopy, in which a thin, flexible, lighted viewing tube is passed into the rectum and through the lower third of the colon (see on later). For either ulcerative colitis or Crohn's disease, a colonscopy (see on later) may be ordered. This procedure allows the doctor to examine almost all the entire length of your colon with the aid of a flexible fibre-optic tube. If you have Crohn's disease, you may undergo regular barium meals, in which you drink a chalky substance that lines the small intestine and allows your doctor to see abnormalities on an X-ray.
If you have advanced IBD and drug therapy isn't helping you, you may need surgery. In the case of ulcerative colitis, that means possibly removing your colon, a colectomy, which will cure the disease. After this procedure, you will need to collect your facial matter either in an extrenal pouch connected to your intestine through your abdomen, called an ostomy, or in an internal pouch made of tissue from your intestines. If you have surgery for Crohn's disease, it usually means removing the part of the intestine with a blockage or abscess. This won't cure the disease, but will allow fluid and food to proceed normally through your digestive tract.
NICOTINE PATCH FOR ULCERATIVE COLITIS
It's rare that you'll hear anyone say anything good about nicotine, but if it's adminstered in the right way, it can be a godsend to ulcerative colitis patients. Although smoking can worsen Crohn's disease, just the opposite happens with ulcerative colitis: it puts patients into remission. Obviously, smoking remains a bad idea for many reasons, but there are ways other than cigarettes to get nicotine into your system.
A transdermal nicotine patch that smokers use to help them break their habit is one example. In a study published by the Mayo Clinic, 12 of 31 patients showed improvement in their mild to moderate ulcerative colitis after four weeks on the patch. If you have ulcerative colitis, talk to your doctor about giving the nicotine patch a try.
Natural methods
Certain herbs may prove helpful in relieving IBD symptoms. They are available in pill, tincture or extract form; teas made from the dried herbs can be useful as well. To calm inflammation, try marsh-mallow root. For a tea, add 30 g of flowers to a litre of boiling water, steep for a few minutes, then strain out the petals. Slippery elm may also be helpful. For a tea, slowly add warm water to 1 heaped teaspoon of dried bark; strain before sipping. To combat unfriendly bacteria in the intestine, try goldenseal. For infections, take 15 drops of extract--sold at health-food stores--every hour. To encourage normal immune function, take echinacea. In capsule form, you need to get at least 900 mg a day.
These herbs are generally safe, but don't take goldenseal if you're pregnant or echinacea if you have an autoimmune disease. Some evidence indicates that echinacea is more effective if you use it for three weeks and then abstain for one. And don't forget a daily multivitamin/mineral. With fluid leaving your body in copious amounts, you may become malnourished. A high-quality multivitamin supplement can help you combat this problem.
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