Inflammatory Bowel Disease Health Article

Allopathic treatment

Inflammation is often treated with an immune-suppressive drug called sulfasalazine. Because of poor absorption, sulfasalazine stays primarily within the intestine, where it is broken down into its two components: an antibiotic and an anti-inflammatory. It is believed to be primarily the anti-inflammatory component, salicylic acid, that is active in treating IBD. For patients who do not respond to sulfasalazine, steroid medications (such as prednisone) are the next choice.

Depending on the degree of blood loss, a patient with IBD may require blood transfusions and fluid replacement through a needle in the vein (intravenous or IV). Medications that can slow diarrhea must be used with great care, because they may actually cause the development of toxic megacolon.

A patient with toxic megacolon requires close monitoring and care in the hospital. He or she will usually be given steroid medications through an IV, and may be put on antibiotics. If these measures do not improve the situation, the patient will have to undergo surgery to remove the colon. This is done because the risk of death after perforation of toxic megacolon is greater than 50%.

A patient with proven cancer of the colon, or even a patient who shows certain precancerous signs, will need a colectomy (colon removal). When a colectomy is performed, a piece of the small intestine (ileum) is pulled through an opening in the abdomen and fashioned surgically to allow attachment of a special bag to catch the body's waste (feces). This opening, which will remain for the duration of the patient's life, is called an ileostomy.

Expected results

Remission refers to a disease becoming inactive for a period of time. The rate of remission of IBD (after a first attack) is nearly 90%. Those individuals whose colitis is confined primarily to the left side of the large intestine have the best prognosis. Those individuals with extensive colitis, involving most or all of the large intestine, have a much poorer prognosis. Recent studies show that about 10% of these patients have died within 10 years after diagnosis. About 20–25% of all IBD patients will require colectomy. Unlike the case for patients with Crohn's disease, however, such radical surgery results in a cure of the disease.

BOOKS

Glickman, Robert. "Inflammatory Bowel Disease: Ulcerative Colitis and Crohn's Disease." In Harrison's Principles of Internal Medicine, edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1998.

Long, James W. The Essential Guide to Chronic Illness. New York: HarperPerennial, 1997.

Saibil, Fred. Crohn's Disease and Ulcerative Colitis. Buffalo, NY: Firefly Books, 1997.

PERIODICALS

"Alternative Therapies Commonly Used by Patients with Inflammatory Bowel Disease." Nutrition Research Newsletter 18 (June 1999):13+.

Campieri, Massimo and Paolo Gionchetti. "Probiotics in Inflammatory Bowel Disease: New Insight to Pathogenesis or a Possible Therapeutic Alternative?" Gastroenterology 116 (1999):1246-1249.

Coghlan, Andy. "Wonderful Worms." New Scientist 163 (August 7, 1999):4.

Hilsden, Robert J. and Marja J. Verhoef. "Complementary and Alternative Medicine: Evaluating its Effectiveness in Inflammatory Bowel Disease." Inflammatory Bowel Diseases 4 (1998):318-323.

Martin, Frances L. "Ulcerative Colitis." American Journal of Nursing 97 (August 1997): 38+.

Peppercorn, Mark A., and Susannah K. Gordon. "Making Sense of a Mystery Ailment: Inflammatory Bowel Disease." Harvard Health Letter 22 (December 1996): 4+.

"Ulcerative Colitis: Manageable, With a Brighter Outlook." Mayo Clinic Health Letter 13 (December 1995): 1+.

ORGANIZATIONS

Crohn's and Colitis Foundation of America, Inc. 386 Park Avenue South, 17th Floor, New York, NY 10016-8804. (800) 932-2423.

Belinda Rowland