Chronic abdominal problems can make you feel truly miserable, even debilitated. It doesn't have to be that way. Finding the right drug or therapy and following some smart self-help strategies can go along away towards restoring a good quality of life.
LIKELY FIRST STEPS
Treatment Options
What is happening
Inflammatory bowel disease, often called IBD, has two main forms: ulcerative colitis and Crohn's disease. Both are chronic conditions with flare-up episodes, followed by periods of remission. If you have either ailment, you know the symptoms all too well: bloody diarrhoea, abdominal cramps and possibly constipation. With Crohn's disease, you may also have significant weight loss.
Ulcerative colitis is inflammation that starts in the rectum but may progress to the rest of your large intestine, which is why getting it under control is important. This inflammation can lead to ulcers in the lining of the bowel or colon, which is some cases eventually becomes rigid and shrinks. Crohn's disease may affect any part of your digestive tract from your mouth to your anus, although it most often occurs in only the last section of your small bowel called the lieum. The affected area becomes swollen and brittle and forms ulcers that go deeper than those of ulcerative colitis. Eventually, Crohn's disease can cause abscesses, narrowings of the intestine called strictures, abnormal connections between organs called fistulas and an overgrowth of surface fat tissue (see illustration below). Efffective new treatments help prevent this.
No-one knows for certain what causes IBD but all signs point to a combination of genetic and environmental factors working together.
Inflammatory bowel disease, often called IBD, has two main forms: ulcerative colitis and Crohn's disease. Both are chronic conditions with flare-up episodes, followed by periods of remission. If you have either ailment, you know the symptoms all too well: bloody diarrhoea, abdominal cramps and possibly constipation. With Crohn's disease, you may also have significant weight loss.
Ulcerative colitis is inflammation that starts in the rectum but may progress to the rest of your large intestine, which is why getting it under control is important. This inflammation can lead to ulcers in the lining of the bowel or colon, which is some cases eventually becomes rigid and shrinks. Crohn's disease may affect any part of your digestive tract from your mouth to your anus, although it most often occurs in only the last section of your small bowel called the lieum. The affected area becomes swollen and brittle and forms ulcers that go deeper than those of ulcerative colitis. Eventually, Crohn's disease can cause abscesses, narrowings of the intestine called strictures, abnormal connections between organs called fistulas and an overgrowth of surface fat tissue (see illustration below). Efffective new treatments help prevent this.
No-one knows for certain what causes IBD but all signs point to a combination of genetic and environmental factors working together.
- Medications to reduce inflammation and treat secondary problems.
- Changes in eating habits to relieve symptoms.
- Regular screening tests to check progress of the disease.
QUESTIONS TO ASK
- How do you know I have IBD and not irritable bowel syndrome?
- Will there ever come a time that I don't have to take medication?
- How likely am I to have to undergo surgery?
Treatment Options
MEDICATIONS
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5-ASA agents Reduce gastrointestinal inflammation.
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Corticosteroids Treat severe IBD inflammation
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Immunosuppressants Slow down attacking immune cells.
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Monocional antibodies For Crohn's combat inflammatory protein.
LIFESTYLE CHANGES
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Diet Get fluids; avoid food irritants; watch weight.
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Stop smoking & get exercise To relieve Crohn's disease.
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Work on stress Practise stress-reduction techniques
PROCEDURES
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Regular screening tests Detect changes in IBD.
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Surgery If drugs don't control IBD.
NATURAL METHODS
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Herbal supplements Marshmallow, slippery elm, goldenseal.
TAKING CONTROL
------------------------------------------------------------------------------------------------------------------------------------------
5-ASA agents Reduce gastrointestinal inflammation.
------------------------------------------------------------------------------------------------------------------------------------------
Corticosteroids Treat severe IBD inflammation
-------------------------------------------------------------------------------------------------------------------------------------------
Immunosuppressants Slow down attacking immune cells.
-------------------------------------------------------------------------------------------------------------------------------------------
Monocional antibodies For Crohn's combat inflammatory protein.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Diet Get fluids; avoid food irritants; watch weight.
----------------------------------------------------------------------------------------------------------------------------------------------
Stop smoking & get exercise To relieve Crohn's disease.
----------------------------------------------------------------------------------------------------------------------------------------------
Work on stress Practise stress-reduction techniques
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Regular screening tests Detect changes in IBD.
---------------------------------------------------------------------------------------------------------------------------------------------
Surgery If drugs don't control IBD.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Herbal supplements Marshmallow, slippery elm, goldenseal.
TAKING CONTROL
- Try a high-fibre supplement. Products with psyllium fibre, such as Metamucil, can be extremely helpful in controlling diarrhoea and constipation. But introduce these supplements gradually, increasing the amount you take by no more than half a teaspoon a day. Make sure you let your doctor know that you intend to try fibre before you take it.
- Experiment with foods. If you find that eating makes your sympotms worse, take away one suspect food at a time for two-week periods and see if you feel better. If you resume eating the food and your symptoms return, eliminate that flood permanentely from your diet.
- Think zinc. This antioxidant mineral removes harmful free radicals from the bloodstream, and may reduce inflammation in the intestines. Zin-rich foods include brown rice, cashew nuts, dark-meat turkey, tofu and swordfish. You should talk to your doctor, however, before taking zinc in concentrated supplement form.
- See your doctor regularly. IBD requires constant monitoring. It's a disease that can progress and become severe if you don't keep an eye on it. And because your risk for colon cancer increases if you've had ulcerative colitis for eight years or longer, make sure you see your doctor for a complete checkup at least once a year to catch and treat any potential malignancy early.
Treatments
The medications your doctor prescribes will reduce inflammation, control diarrhoea or constipation and treat secondary problems, such as infection. If your disease is in the lower colon, your medication may be in the form of an enema or suppository. If it is higher in your digestive tract, pills or injections may be the best solution.
For moderate IBD (less than six stools per day) the first drug your doctor is likely to prescribe is a 5-ASA agent, with an inflammation-controlling susbtance called mesalamine. These agents include sulfasalazine (Salazopyrin), and the newer drugs Mesasal, Dipentum and Salofalk (which is also available in enema form).
Most treatments for IBD are aimed at controlling your symptoms and halting the progress of the disease. People with IBD usually do very well when they're on the right medication and also makes some changes in their eating habits. As time goes on, some people may need to turn to surgical alternatives, and with ulcerative colitis, surgery can actually provide a complete cure.
MedicationsThe medications your doctor prescribes will reduce inflammation, control diarrhoea or constipation and treat secondary problems, such as infection. If your disease is in the lower colon, your medication may be in the form of an enema or suppository. If it is higher in your digestive tract, pills or injections may be the best solution.
For moderate IBD (less than six stools per day) the first drug your doctor is likely to prescribe is a 5-ASA agent, with an inflammation-controlling susbtance called mesalamine. These agents include sulfasalazine (Salazopyrin), and the newer drugs Mesasal, Dipentum and Salofalk (which is also available in enema form).
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