Treatment for Ulcerative Colitis
Ulcerative Colitis is the most common inflammatory bowel disease affecting Americans every year with a record of up to 12 cases per 100,000 people. It is one of the most underrated health conditions and one of the most serious diseases accompanied by a high mortality rate. Until now, the treatment model for Ulcerative Colitis involves medication, therapy, and surgery. This article will discuss the medical and surgical management of ulcerative colitis and their implications. We will cover the following six topics:
- Definition of Ulcerative Colitis
- Treatment with medication
- Treatment using biologic therapies
- Treatment using whipworm therapies
- Treatment by surgical intervention
- What are Ostomy Bags?
Definition of Ulcerative Colitis
Ulcerative Colitis is a bowel disorder characterized by inflammation of colonic cells and development of multiple ulcerations. Due to shedding of cells in the colon, bleeding may occur and abscesses may form. The highest prevalence of ulcerative colitis is noted among Caucasians and individuals of Jewish descent. Clinical manifestations of ulcerative colitis include lower quadrant abdominal pain, intermittent diarrhea, rectal bleeding and tenesmus (the feeling of a constant urge to pass stool).
Treatment of Ulcerative Colitis with Medication
The baseline treatment of ulcerative colitis is medication. Anti-inflammatory drugs and immunosuppressants are common drugs of choice. Anti-inflammatory drugs such as aminosalicylate formulations are used as long-term maintenance to manage chronic bowel inflammation. On the other hand, the mode of action of immunosuppressants is to weaken the body’s immune response. They are used to treat severe conditions when anti-inflammatory drugs are not effective. Immunosuppressant medications are a lot stronger, making them a more effective treatment for ulcerative colitis. However, their usage may often cause serious side effects.
Treatment of Ulcerative Colitis using Biologic Therapy
Biologic therapy involves the use of specialized drugs that target immune mediators of the body. It is believed that Ulcerative Colitis is a result of an abnormal immune response that causes atypical cells to attack healthy cells. Biologic therapy for Ulcerative Colitis includes the use of Alpha-4 integrins and Visilizumab that work by targeting T-cells in the intestines. Individuals using biologic therapy may experience severe reactions such as anaphylaxis, worsening body condition, tuberculosis, serum sickness, lymphoma and hypersensitivity response.
Treatment of Ulcerative Colitis using Whipworm Therapies
Also called helminthic therapy, whipworm therapy is done by oral ingestion of fertilized eggs or by skin penetration of parasitic worms. Whipworm therapy is backed by scientific studies and research in delaying ulcerative colitis attacks. Helminths, particularly whipworms and hookworms, are now gaining consideration in medicine as modern therapeutic agents for ulcerative colitis and other inflammatory bowel disease.
Treatment of Ulcerative Colitis by Surgical Intervention
Surgical intervention is the last resort for ulcerative colitis whenever other methods of management fall short. According to reports, individuals suffering from ulcerative colitis are likely to undergo surgery within five years of diagnosis. Surgery is indicated for individuals who experience debilitating symptoms and a poor quality of life. The success rate of surgery is high. Patients who have had a total colectomy have tolerated the procedure and were able to live a more normal life. On the other hand, individuals with severe regional enteritis may undergo ileostomy and a total colectomy.
Another surgical management of ulcerative colitis is restorative proctocolectomy with IPAA (Ileal Pouch Anal Anastomosis). This is a surgical procedure in which the rectum is reconstructed from the small bowel to prevent a permanent ileostomy. In a restorative proctocolectomy, the diseased colon and the rectum are removed while the anal sphincter is preserved. A temporary ileostomy is created while the ileoanal anastomosis heals.
Individuals with a rectum badly affected by the disease may undergo a continent ileostomy which involves the creation of a ileal reservoir (e.g.Kock pouch) by diverting the distal ileum of the small intestine to the abdominal wall through a stoma. The advantage of a continent ileostomy is that it does not require the use of a fecal collection bag. A continent ileostomy is also indicated for patients who have no rectal sphincter tone and those who are unable to achieve fecal incontinence post-IPAA.
What Are Ostomy Bags in the Treatment of Ulcerative Colitis?
Ostomy bags or ostomy pouching systems are medical devices that function as waste collectors (urine, feces) following the creation of the stoma. Ostomy bags are associated with ileostomy and colostomy procedures. Most ostomy bags are designed with an air-tight and water-tight seal to avoid leakage that may result in skin breakdown. Ostomy bags are also called stoma appliances.