Treatment
Management in Crohn's disease vs. ulcerative colitis
|
||
|---|---|---|
| Crohn's disease | Ulcerative colitis | |
| Mesalamine | Less useful | More useful |
| Antibiotics | Effective in long-term | Generally not useful |
| Surgery | Often returns following removal of affected part |
Usually cured by removal of colon |
Optimal treatment of inflammatory bowel disease depends on what form it consists of. For example, mesalazine is more useful in ulcerative colitis than in Crohn's disease. Generally, depending on the level of severity, IBD may require immunosuppression to control the symptom, such as prednisone, TNF inhibition, azathioprine (Imuran), methotrexate, or 6-mercaptopurine. More commonly, treatment of IBD requires a form of mesalazine.
Often, anti-inflammatory steroids are used to control disease flares and were once acceptable as a maintenance drug. In use for several years in Crohn's disease patients and recently in patients with ulcerative colitis, biologicals have been used such as TNF inhibitors. Severe cases may require surgery, such as bowel resection, strictureplasty or a temporary or permanent colostomy or ileostomy. Alternative medicine treatments for bowel disease exist in various forms, however such methods concentrate on controlling underlying pathology in order to avoid prolonged steroidal exposure or surgical excisement.
Usually the treatment is started by administering drugs with high anti-inflammatory effects, such as prednisone. Once the inflammation is successfully controlled, the patient is usually switched to a lighter drug to keep the disease in remission, such as Asacol, a mesalazine. If unsuccessful, a combination of the aforementioned immunosuppression drugs with a mesalazine (which may also have an anti-inflammatory effect) may or may not be administered, depending on the patient.
Histoplasma produces toxins that cause intestinal disease called histoplasmosis that is a “serious consideration” in an immunocompromised patient with signs and symptoms of IBD. Antifungal drugs such as nystatin (a broad spectrum gut antifungal) and either itraconazole (Sporanox) or fluconazole (Diflucan) have been suggested as a treatment for IBD disorders such as Crohn’s disease and ulcerative colitis that all share the same symptoms such as diarrhea, weight loss, fever, and abdominal pain.
A relatively new treatment option is fecal bacteriotherapy (FBT), which has been used to successfully treat IBD in several small studies. A memoir of home treatment of IBD with fecal bacteriotherapy, "Ulcerative Colitis from the Bottom Up," has been published as an ebook at Smashwords.com.
Read more about this topic: Inflammatory Bowel Disease
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