Why Choose Cedars-Sinai Marina del Rey Hospital for Ulcerative Colitis Treatment?
Cedars-Sinai Marina del Rey Hospital works with experienced and skilled specialists who can help you with treatment options for ulcerative colitis. They know how important it is to personalize the treatment according to each patient’s health problems and particular needs. Our specialists are constantly looking to improve themselves as doctors in order to be able to provide the best healthcare for their patients.
Ulcerative colitis is an inflammatory bowel disease that causes ulcers (lesions of the tissue) in the large intestine. Ulcerations are formed in areas where intestinal mucosal cells have been destroyed by infection and can be accompanied by bleeding.
Although it usually affects the sigmoid and the rectum, the extent of the disease may range from a simple affection of the rectum to considerable damage of the colon. The affected colon area serves as an indicator of the severity of the disease.
Ulcerative colitis can occur in people of all ages, but most of the times patients are aged between 15 and 30 years. It affects both men and women to the same extent and often manifests itself in several members of the same family.
Drugs for Ulcerative Colitis
Drug therapy is essential for ulcerative colitis as it controls and prevents intestinal inflammation. Medication helps diminish the symptoms, heal the lesions, achieve disease remission and delay the surgical treatment. Ulcerative colitis therapy mainly depends on the severity of the disease.
- antidiarrheal medication and diet changes
- disease remission stimulators: corticosteroids (hydrocortisone or prednisone)
- aminosalicylates (sulfasalazine or mesalazine), which maintain the remission of the disease and reduce the inflammation of the intestine
- cortisone therapy with higher levels of steroids in order to achieve inflammation control
- further aminosalicylates medication once the disease is in remission
- suppressors of the immune system: immunomodulatory therapy (azathioprine or 6-mercaptopurine) when aminosalicylates fail to control the evolution of the disease
Other Types of Treatments for Ulcerative Colitis
Several studies have shown that nicotine patches can be used as adjuvants in the treatment of ulcerative colitis. The patches are useful for people whose symptoms get worse or appear after quitting smoking. However, due to harmful addiction effects of nicotine, this type of treatment is not recommended for wide use.
Currently Tested Drugs
Other drugs used to suppress the immune system are still tested. For example, CDP571 is an antibody which acts against the tumor necrosis factor (increased in inflammation). Studies on this product have shown that it might be useful in colitis with mild or moderate symptoms.
Surgical Treatment for Ulcerative Colitis
Surgery is used as a last option when other therapies are not effective or if complications arise. Proctectomy, the surgical intervention consisting of the ablation of the colon and anal sphincter is the only method of healing ulcerative colitis. Depending on the extent and severity of the disease, one of the following procedures is used:
- ileoanal or ileorectal anastomosis: removal of the colon and a subsequent anastomosis of the remaining intestine and rectum
- ileostomy: removal of both the colon and rectum, closing of the anal orifice and connection of the ileum to a stoma (tissue opening) previously created in the abdomen
Depending on the affected part of the intestine, several types of ulcerative colitis can be described:
- Proctitis: a type of colitis which causes lesions of the rectum
- Distal colitis: colitis which only affects the left part of the colon (the sigmoid)
- Extensive colitis (pancolitis): this disease affects the whole colon and it is the most dangerous type of colitis as it can lead to the developing of colon cancer
Symptoms of Ulcerative Colitis
Symptoms of this disease may vary depending on its severity and can show up or not. In some cases, people might even have a large part of the colon affected by the disease and show no symptoms of being sick. Signs of ulcerative colitis usually include:
Diagnosis of Ulcerative Colitis
Several tests need to be done in order to diagnose ulcerative colitis. The first step, however, consists of a general consult of the patient and getting familiar with the patient's medical history.
Blood tests are required for a possible anemia diagnosis, which may indicate the presence of intestinal or rectal bleeding. These tests are also useful in finding the number of white cells in the patient's blood as a large number of such cells is a sign that the body is battling an infection.
Faeces examination might also show the presence of leukocytes, possibly pointing to an ulcerative colitis diagnosis or another inflammatory disease. Moreover, the results of this analysis are useful in finding whether bleeding or infection is present in the colon or not and if there is any bacteria, virus or parasite that might have caused these problems.
Investigations of the colon such as colonoscopy and sigmoidoscopy are the most accurate methods of diagnosing ulcerative colitis and eliminate suspicions of other possible affections, such as Crohn's disease, diverticular disease or cancer.
Barium enema and computed tomography scans (CT) are also used to diagnose ulcerative colitis or its complications.
Risk Factors for Ulcerative Colitis
Age. Ulcerative colitis usually occurs before the age of 30 but can develop at any age.
Ethnicity. White people have the highest risk of developing ulcerative colitis.
Hereditary factors. The risk of developing ulcerative colitis increases if other family members have ulcerative colitis and it is the highest if first degree relatives have this disease.
Genetic and environmental factors. Stress, poor and unvaried alimentation and food intolerances can influence the development of ulcerative colitis but are not considered to be a cause of the disease.
Causes of Ulcerative Colitis
The causes of ulcerative colitis are still unknown but certain studies have suggested that this intestinal inflammatory disease can be caused by an abnormal immune system response to intestinal bacteria.
Ulcerative colitis is not caused by stress or sensitivity to certain food, but these factors, along with other risk factors such as age and medical history of family members, can trigger disease-specific symptoms in some patients. Stress suffered by ulcerative colitis sufferers can even help worsen symptoms.
Many people add non-traditional medicine to classical therapy. They choose to use these procedures because in classical medicine there is no healing therapy for ulcerative colitis, except for surgical removal of the colon. Natural remedies for this disease include:
- vitamin D: stimulates the calcium and phosphorus resorption in the intestine
- vitamin B12: contributes to physical development, increased appetite and body weight
- administration of herbs, such as aloe and ginseng
- iron supplements: control of anemia
- special diets or nutritional supplements such as probiotics: speed up the recovery process of the intestinal tissue
- massage, stimulation of legs, hands, ears to influence different parts of the body (reflexology)
Although there is no treatment to cure this disease, it can be kept under control with medication and may even get into remission. Food is the best ally in the fight against the symptoms of this disease, so it is important to have an optimal daily diet. Keep in mind the following pieces of advice:
Regularly administered medication can also help in reducing anxiety episodes and maintaining disease in the remission phase. Experts recommend administration of acetaminophen in order to reduce pain instead of non-steroidal anti-inflammatory drugs, as they have been accompanied by irritable bowel syndrome accidents. Antibiotics worsen the symptoms of ulcerative colitis and should only be used if necessary.