What ulcerative colitis medications are available?
5-ASA Compounds (Azulfidine, Asacol, Pentasa, Dipentum): 5-ASA (5-aminosalicylic acid), also called mesalamine, is chemically similar to aspirin. Aspirin (acetylsalicylic acid) has been used for many years in treating arthritis, bursitis, and tendinitis (conditions of tissue inflammation). Aspirin, however, is not effective in treating ulcerative colitis. On the other hand, 5-ASA can be effective in treating ulcerative colitis if the drug can be delivered directly (topically) onto the inflamed colon lining. For example, Rowasa enema is a 5-ASA solution that is effective in treating inflammation in and near the rectum
(ulcerative proctitis and ulcerative proctosigmoiditis). However, the enema solution cannot reach high enough to treat inflammation in the upper colon. Therefore, for most patients with ulcerative colitis, 5-ASA must be taken orally. When pure 5-ASA is taken orally, however, the stomach and upper small intestine absorb most of the drug before it reaches the colon. Therefore, to be effective as an oral agent for ulcerative colitis, 5-ASA has to be modified chemically to escape absorption by the stomach and the upper intestines. These modified 5-ASA compounds are sulfasalazine (Azulfidine), mesalamine (Pentasa, Asacol), and olsalazine (Dipentum).
Antidiarrheal Drugs: Anticholinergic drugs or small doses of loperamide or diphenoxylate are taken for relatively mild diarrhea. For more intense diarrhea, higher doses of diphenoxylate or deodorized opium tincture, loperamide, or codeine may be needed. In severe cases, a doctor closely monitors the person taking these antidiarrheal drugs to avoid precipitating toxic megacolon.
Steroids - Steroids are powerful drugs that reduce inflammation and suppress the body's immune system. Steroids can be applied topically by enema (easily placed directly into the rectum) for treatment of proctitis, proctosigmoiditis, and left-sided colitis, or taken by mouth for pancolitis or for any disease that does not respond to topical steroids. Steroids are used to treat moderate-to-severe symptoms during a flare-up. Steroids have not been shown to be beneficial as a maintenance therapy, and individuals should be weaned off steroids as quickly as possible. Prednisone and prednisolone are the most commonly used steroids for ulcerative colitis treatment. While they are very useful, they also can produce a number of side effects, which range from annoying to dangerous. Some side effects are more often seen with long-term use, while others can appear from even short-term use. Drugs such as sulfasalazine, olsalazine, mesalamine, and, most recently, balsalazide, are used to reduce the inflammation of ulcerative colitis and to prevent flare-ups of symptoms. These drugs usually are taken by mouth, but mesalamine can also be given as an enema or a suppository. Whether given by mouth or rectally, these drugs are at best moderately effective for treating mild or moderately active disease and for maintaining remission.
Immunosuppressive Drugs: Drugs such as azathioprine and mercaptopurine have been used to maintain remissions in people with ulcerative colitis who would otherwise need long-term corticosteroid therapy. These drugs inhibit the function of T cells, which are an important component of the immune system. However, these drugs are slow to act, and a benefit may not be seen for 2 to 4 months. They also have potentially serious side effects that require close monitoring by the doctor. Cyclosporine has been given to some people who are suffering severe flare-ups and have not responded to corticosteroid therapy. Many of these people respond initially to the cyclosporine, but some may still ultimately require surgery.
More information on inflammatory bowel diseases (ulcerative colitis, Crohn's disease)
What are the inflammatory bowel diseases? - Inflammatory bowel disease (IBD) is a chronic disorder that causes an inflamed and swollen digestive tract or intestinal wall.
What causes inflammatory bowel diseases? - The cause of inflammatory bowel disease is not known. Chronic inflammation present in the intestines of persons with both forms of IBD damages the bowel.
What are the symptoms of inflammatory bowel diseases? - Symptoms of inflammatory bowel diseases can include chronic diarrhea, abdominal cramps or pain, fever, and blood or mucus in the stool.
How is inflammatory bowel disease diagnosed? - To make a diagnosis of inflammatory bowel disease, a doctor must first exclude other possible causes of inflammation.
What're the treatments for inflammatory bowel disease? - Inflammatory bowel disease is treated with medication, exercise, and sometimes, surgery. Treatments for IBD are directed against the inflammation in the bowel.
What're the medications for inflammatory bowel disease? - Medications for inflammatory bowel disease include sulfasalazine, corticosteroids, immunosuppressives, and nonsteroidal anti-inflammatory drugs (NSAIDs).
What is Crohn's disease? - Crohn's Disease is a chronic illness that causes irritation in the digestive tract. Crohn's disease occurs in the last portion of intestine (ileum).
What types of Crohn's disease are there? - There are five subtypes of Crohn's disease, distinguished by the gastrointestinal area in which the disease occurs.
What causes Crohn's disease? - The cause of Crohn's disease is unknown. There is now evidence of a genetic link as Crohn's frequently shows up in a family group.
What are the symptoms of Crohn's disease? - The symptoms of Crohn's disease include abdominal pain, diarrhea, fever, loss of appetite and weight loss.
What are the complications of Crohn's disease? - Common complications of Crohn's disease include the development of an intestinal obstruction, pus-filled pockets of infection, and abnormal connecting channels.
How is Crohn's disease diagnosed? - The diagnosis of Crohn's disease is suspected in patients with fever, abdominal pain and tenderness, diarrhea with or without bleeding, and anal diseases.
What're the treatments for Crohn's disease? - Treatment for Crohn's disease is mainly symptomatic. Medications are very effective at improving the symptoms of Crohn's disease.
What medications cure Crohn's disease? - Medications for Crohn's disease sulfasalazine, Asacol, Pentasa and Dipentum. Mesalamine is useful both to achieve and maintain remission.
What's the surgery for Crohn's disease treatment? - Surgery to remove part of the intestine can help Crohn's disease but cannot cure it. The most used operation in Crohn disease is removing the diseased part of the intestine.
What Crohn's disease diet is suggested? - Diet may have to be restricted based on symptoms or complications of Crohn's disease. No particular food has ever been implicated in causing Crohn's disease.
Crohn's disease in children - Crohn's disease is most often diagnosed in young adulthood. Children facing Crohn's disease have significant self-image issues to deal with.
Crohn's disease and pregnancy women - Women with Crohn's disease who are considering having children can be comforted to know that the vast majority of such pregnancies will result in normal children.
What is ulcerative colitis? - Ulcerative colitis is an inflammatory disease of the bowel, that usually affects the distal end of the large intestine and rectum.
What types of ulcerative colitis are there? - Doctors categorize ulcerative colitis by the amount of colon involved. Variability of symptoms reflects differences in the extent of disease and the intensity of inflammation.
What causes ulcerative colitis? - The cause of ulcerative colitis is not known, but heredity and an overactive immune response in the intestine may be contributing factors.
What are the symptoms of ulcerative colitis? - The symptoms vary according to the extent of the disease. The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea.
What are the complications of ulcerative colitis? - Bleeding, the most common complication of ulcerative colitis, often causes iron deficiency anemia.
How is ulcerative colitis diagnosed? - Diagnosis of ulcerative colitis is suspected based on the symptoms that a patient is experiencing. The most important method of diagnosis is endoscopy.
What are the treatments for ulcerative colitis? - Treatment of ulcerative colitis depends on the location and severity of a patient's disease, the presence of complications.
What ulcerative colitis medications are available? - Medications for ulcerative colitis include 5-ASA Compounds, anticholinergic drugs, steroids, and immunosuppressive drugs.
What surgery treats ulcerative colitis? - Surgery for ulcerative colitis involves removal of the entire colon, regardless of whether all or only a portion of the colon is diseased.
Collagenous colitis and lymphocytic colitis - Collagenous colitis and lymphocytic colitis are chronic diseases in which certain kinds of white blood cells infiltrate the lining of the large intestine.