In a previous issue, we discussed the factors and causes that lead to Crohn’s disease and ulcerative colitis.
The two diseases are often diagnosed after all other possible causes have been ruled out, as are many digestive possibilities.
Blood tests. In addition to the initial analysis, abnormalities in the erythrocyte sedimentation rate or in the level of C-reactive protein may indicate the presence of inflammation. Two newer tests, PANCA and ASCA, can diagnose inflammatory bowel disease. However, their accuracy ranges between 80 and 90 percent.
X-ray pictures. Images of the small and large intestine may reveal ulceration, swelling, or other complications such as a narrowing or fistula.
Colonoscopy. It is the critical test for diagnosing Crohn’s disease or ulcerative colitis. The doctor inserts a thin, flexible tube equipped with a camera into the colon. The presence of one persistent inflammation indicates the possibility of ulcerative colitis. Tissue that has normal sections between areas of inflammation is indicative of Crohn’s disease.
During the test, the doctor may invent tissue samples that are later examined under a microscope. The presence of granulomas in specimens may confirm Crohn’s disease, but these tumors are rarely found. Granulomas are small groups of inflammatory cells that usually surround and try to destroy bacteria and other foreign bodies. These tumors are not associated with colitis.
It is not possible to cure IBD with drugs, but it is successful in relieving symptoms in most patients. The first goal of treatment is to relieve IBD in various ways. Some drugs work effectively for some and fail for others. So finding out which drug or combination of drugs is most appropriate for your condition may take time.
Anti-inflammatory drugs:
sulfasalazine. This drug has been prescribed for mild to moderate cases of Crohn’s disease and ulcerative colitis since the 1940s, and sulfasalazine (Azulfidine) is often effective in relieving symptoms of both diseases, and it helps prevent the recurrence of ulcerative colitis, but the drug has side effects, including loss of appetite, nausea and vomiting. In addition to the rash and headache.
mesalamine and olsalazine. Doctors are recently turning to prescribing these drugs. Mesaline (Asacol, Pentasa.Rowasa) and olsalazine (Dipentum) work similarly to sulfalazine, but with fewer side effects. Similar to sulfasalazine, both drugs can be taken orally as tablets, or rectally as injections or suppositories.
steroids; Steroids are effective in reducing inflammation regardless of the location of the disease, but they can cause many side effects, including facial puffiness, acne, excessive facial hair growth as well as nocturia, insomnia, irritability and hyperactivity. Among its most serious side effects (when used for long periods) are high blood pressure, diabetes and osteoporosis, in addition to blue water, black water and an increased risk of bacterial infections. In children, prolonged use of steroids can stunt growth.
Immune system suppressants:
These medications also reduce inflammation, but in a different way. It targets the immune system, which may be the cause of inflammation or one of the co-factors. One theory is that the cause of IBD may be an over-response of the immune system to an unknown virus or bacteria. In order to destroy or expel this foreign body, the immune system releases irritating chemicals that can damage digestive tissue over time, causing inflammation.
Immune-suppressing drugs eliminate IBD by suppressing the immune system’s ability to release chemicals that resist foreign bodies:
Azathioprine and 6-mercaptopurine are the most commonly used inhibitors for treating inflammatory bowel disease. However, its effect may take up to three months before it begins to appear. It is still not entirely clear how it works, but studies have shown the effectiveness of azathioprine (Imuran) and 6(6-M) mercaptopurine in relieving IBD symptoms and healing Crohn’s disease fistulas.
Infliximab (Remicade) and Humira. The FDA recently approved these immunosuppressants specifically for people with moderate to severe Crohn’s disease, and they are bioengineered to block a natural protein called tumor necrosis factor that causes inflammation.
Clinical trials have shown that more than 60 percent of people treated with a single intravenous dose of infliximab experienced relief after 4 weeks. The drug also reduced the number of fistulas. However, it was noted that the effect of the drug declined with time, in addition to the fact that the safety of its use is not guaranteed due to its recentness.
methotrexate; This medicine has long been used to treat psoriasis and rheumatoid arthritis, as well as cancer. It is sometimes prescribed for people with Crohn’s disease and ulcerative colitis, and for those who tolerate or do not respond well to other medications, and its short-term side effects sometimes include nausea. The long-term use of the drug may lead to scarring of the liver.
Antibiotics:
Antibiotics are generally not effective for ulcerative colitis, but they can heal fistulas and abscesses and relieve Crohn’s disease symptoms in some.
@ Coping with the disease:
In addition to medications, the following measures help relieve symptoms and prolong the time between flare-ups:
Limit dairy, reduce fiber intake, reduce fat, ask for a multivitamin, have more fluids, and reduce stress.
Surgical treatment:
Based on statistics, 25-40% of people with Crohn’s disease and ulcerative colitis fail medications or life changes or experience limited improvement, so the next step is often surgery.
In the case of Crohn’s disease, removing part of the small or large intestine can provide years of recovery or improvement in symptoms. During surgery, parts of the intestine are reconnected after removing the damaged parts. The surgeon may also close the fistula and remove the scar tissue that is blocking or narrowing the intestinal tract. However, surgery is not a curative treatment in most cases. This is because the disease may reappear elsewhere in the gastrointestinal tract
