Drug therapy for ulcerative colitis

Abstract

Ulcerative colitis (UC) is an inflammatory destructive disease of the large intestine occurred usually in the rectum and lower part of the colon as well as the entire colon. Drug therapy is not the only choice for UC treatment and medical management should be as a comprehensive whole. Azulfidine, Asacol, Pentasa, Dipentum, and Rowasa all contain 5-aminosalicylic acid (5-ASA), which is the topical anti-inflammatory ingredient. Pentasa is more commonly used in treating Crohn's ileitis because Pentasa capsules release more 5-ASA into the small intestine than Asacol tablets. Pentasa can also be used for treating mild to moderate UC. Rowasa enemas are safe and effective in treating ulcerative proctitis and proctosigmoiditis. The sulfafree 5-ASA agents (Asacol, Pentasa, Dipentum and Rowasa) have fewer side effects than sulfa-containing Azulfidine. In UC patients with moderate to severe disease and in patients who failed to respond to 5-ASA compounds, systemic (oral) corticosteroids should be used. Systemic corticosteroids (prednisone, prednisolone, cortisone, etc.) are potent and fast-acting drugs for treating UC, Crohn's ileitis and ileocolitis. Systemic corticosteroids are not effective in maintaining remission in patients with UC. Serious side effects can result from prolonged corticosteroid treatment. To minimize side effects, corticosteroids should be gradually reduced as soon as the disease remission is achieved. In patients with corticosteroid-dependent or unresponsive to corticosteroid treatment, surgery or immunomodulator is considered. Immunomodulators used for treating severe UC include azathioprine/6-MP, methotrexate, and cyclosporine. Integrated traditional Chinese and Western medicine is safe and effective in maintaining remission in patients with UC.Xu CT, Meng SY, Pan BR. Drug therapy for ulcerative colitis.

Epidemiology and gene markers of ulcerative colitis in the Chinese

“…Immunomodulators used for treating severe UC include azathioprine/6-MP, methotrexate and cyclosporine. Integrated traditional Chinese and modern medicine is safe and effective in maintaining remission in patients with UC [1,11,46] . There are also complementary and alternative therapies for IBD [47] .…”

Drug Therapy in Ulcerative Colitis

“…The goals of treatment of UC are to induce and maintain remission of symptoms and inflammation of the inner lining of colon [2,4,6,7]. Treatment options are determined according to the extent of the inflammation and the severity of the disease.…”

“…Mesalamine enemas can relieve signs and symptoms in more than 80 percent of people with ulcerative colitis in the lower left side of their colon and rectum. Olsalazine may cause or worsen existing diarrhea in some people [2][3][4]. Balsalazide is more effective than mesalazine in induction of remission, but balsalazide has no benefit compared with mesalazine in preventing relapse in the population selected.…”

“…They may also be used in conjunction with other medications as a means to induce remission. These, too, are only for short-term use [2,8]. MEDLINE, EMBASE, and the Cochrane central register of controlled trials were searched (through December 2010) by Ford et al [26].…”

“…Peak incidence is between the ages of 10 and 40 years. UC may affect people of any age and 15% of people are over the age of 60 at diagnosis [1][2][3][4]. The incidence of UC in North America is 10-12 cases per 100,000, with a peak incidence of UC occurring between the ages of 15 and 25.…”