Posts Tagged ‘Anti Inflammatory Drugs’

Lymphocytic Colitis

05.08.10

Lymphocytic colitis, a subtype of microscopic colitis, is a rare condition characterized by chronic non-bloody watery diarrhea. The colonoscopy is normal but the mucosal biopsy reveals an accumulation of lymphocytes in the colonic epithelium and connective tissue (lamina propria).

No definite etiology has been determined. Some reports have implicated long-term usage of NSAIDs, antidepressants, and other drugs; and overactive immune responses are also suspected. Over-the-counter antidiarrheal drugs are effective for many people with lymphocytic colitis. Anti-inflammatory drugs, such as salicylates may also help.

Corticosteroids or Mesalazines may be prescribed for people who do not respond to other drug treatment. The long-term prognosis for this disease is not clear. Lymphocytic colitis is closely related to collagenous colitis. Both are characterized by a syndrome of watery diarrhea, usually occurring in young to middle aged women. The etiology is unknown but an autoimmune basis has long been suspected.

However, an infectious etiology has not been excluded. In favor of an infectious etiology are cases associated with an outbreak of Brainerd diarrhea aboard a cruise ship. Brainerd diarrhea has been applied to cases of diarrhea of unknown etiology with an acute onset and prolonged duration.

Like collagenous colitis, a chronic watery diarrhea is present, but this lasts longer than 6 months and frequently for many years. Biopsies show similar features to lymphocytic colitis except there may a lesser degree of lymphocytic infiltration. lymphocytic colitis, is considered now an important cause of diarrhea in middle aged and elderly patients.

In this entity, endoscopic and radiological examinations are normal while specific histological findings are seen on colonic biopsy. Once the diagnosis of MC is confirmed, a stepwise approach with medical therapy is suggested. Ruling out other causes of chronic diarrhea should be the initial step. Once the diagnosis of MC is confirmed, a stepwise treatment algorithm is suggested.

In this review, I will introduce the entity of MC and describe the stepwise approach to diagnosis and management by reviewing the available evidence. The literature was reviewed regarding both collagenous colitis and lymphocystic colitits focusing on clinical trails. This was then critically examined and an approach to the diagnosis and management of microscopic colitis was suggested. there is inflammation in the lamina propria of the colonic mucosa, with increased intraepithelial lymphocytes.

Specifically in CC and not in LC, there is, in addition, marked thickening of the sub-epithelial collagen layer, which is the hallmark of this disease. This disease entity has attracted a lot of attention recently as an important and relatively common cause of chronic diarrhea.

The initial description of MC was first published in 1976 and since that time, it has been increasingly recognized as a relatively common cause of chronic diarrhea.

Treatment for Crohns Disease

04.29.10

Crohns Disease treatment is a life-long commitment, as this chronic condition is marked by flare-ups and remission periods that sufferers will unfortunately be forced to deal. Crohns Disease symptoms, and possibly one or more stays in a hospital.

All of that works together with the general stress of life to affect the course of your disease. When it all combines together — you get fatigue. You feel tired, listless. I know. I’ve been there. Proper Crohns Disease treatment is crucial, and it is important to learn everything you can about this debilitating condition.

The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Treatment for Crohns disease usually involves drug therapy or, in certain cases, surgery.

Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you.

In addition, because some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.
Anti-inflammatory drugs
Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease.

They include:
• Sulfasalazine (Azulfidine). Doctors have used this drug for many years to treat Crohns disease. Although it can be effective in reducing symptoms of the disease, it has a number of side effects, including nausea, vomiting, heartburn and headache. Don’t take this medication if you’re allergic to sulfa medications.
• Mesalamine (Asacol, Rowasa). This medication tends to have fewer side effects than sulfasalazine has. You take it in tablet form or use it rectally in the form of an enema or suppository, depending on which part of your colon is affected.
• Corticosteroids. Corticosteroids can help reduce inflammation anywhere in your body, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity.

More serious side effects include high blood pressure, type 2 diabetes, osteoporosis, bone fractures, cataracts and an increased susceptibility to infections. Long-term use of corticosteroids in children can lead to stunted growth.

Also, these medications don’t work for everyone with Crohns disease. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease that doesn’t respond to other treatments.

A newer type of corticosteroid, budesonide (Entocort EC), works faster than do traditional steroids and appears to produce fewer side effects. Entocort EC is effective only in Crohns disease that involves the lower small intestine and the first part of the large intestine (ileocolitis).

Corticosteroids aren’t for long-term use. They can be used for short-term symptom improvement for about three to four months. They’re also used in conjunction with other medications as a means to induce remission.

For example, corticosteroids may be used with an immune system suppressor — the corticosteroids can induce remission, while the immune system suppressors can help maintain remission.

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Colitis Ulcerosa

07.13.09

Ulcerative colitis (Colitis ulcerosa, UC) is a form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon, that includes characteristic ulcers, or open sores, in the colon.

The main symptom of active disease is usually diarrhea mixed with blood, of gradual onset. Ulcerative colitis is, however, a systemic disease that affects many parts of the body outside the intestine. Because of the name, IBD is often confused with irritable bowel syndrome (“IBS”), a troublesome, but much less serious condition. Ulcerative colitis has similarities to Crohns disease, another form of IBD.

Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission.Ulcerative colitis is a rare disease, with an incidence of about one person per 10,000 in North America.

The disease tends to be more common in northern areas. Although ulcerative colitis has no known cause, there is a presumed genetic component to susceptibility. The disease may be triggered in a susceptible person by environmental factors. Although dietary modification may reduce the discomfort of a person with the disease, ulcerative colitis is not thought to be caused by dietary factors. Although ulcerative colitis is treated as though it were an autoimmune disease, there is no consensus that it is such.

Treatment is with anti-inflammatory drugs, immunosuppression (suppressing the immune system), and biological therapy targeting specific components of the immune response. Colectomy (partial or total removal of the large bowel through surgery) is occasionally necessary, and is considered to be a cure for the disease. Ulcerative colitis is a relatively uncommon, chronic, recurrent inflammatory disease of the colon or rectal mucosa. Often a lifelong illness, the condition has profound emotional and social impact on the affected individual. Ulcerative colitis is defined as continuous idiopathic inflammation of the colonic or rectal mucosa.

The rectum is involved in more than 95% of cases. Some authorities believe that the rectum is always involved in an untreated patient. Partial healing may occur in a patient treated with topical therapy, creating diagnostic confusion. Ulcerative colitis occurs more frequently in white people. The incidence of ulcerative colitis is reported to be 2-4 times higher in Jewish people. However, recent population studies in North America do not completely support this assertion. Ulcerative colitis seems to have a female preponderance. Ulcerative colitis affects 30% more females than males. The incidence of ulcerative colitis peaks in people aged 15-25 years and in people aged 55-65 years, although it can occur in people of any age.

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