How Anti-inflammatory Drugs Can Help Crohn's Disease And Ulcerative Colitis

Crohn's disease and ulcerative colitis are chronic disorders of the digestive system

. Symptoms are controlled using anti-inflammatory drugs to soothe inflammation and anti-spasmodics to reduce painful smooth muscle spasms.

Inflammatory bowel disease affects the lives of around 100 000 people in the UK alone and its incidence is increasing. Treatment is difficult because we do not yet understand the root cause of the inflammation that leads to symptoms such as chronic diarrhoea, ulceration of the bowel, bleeding and pain. But these symptoms must be treated with safe anti-inflammatory medication to help patients cope with their debilitating condition.

Treating Crohn's disease with anti-inflammatories

Crohn's disease involves inflammation of all segments of the intestine, including the large bowel and rectum. It is thought to arise when the immune system of the body reacts against bacteria in the gut, over-stimulating the localised immune response. Steroidal antiinflammatory drugs are better than nonsteroidal antiinflammatory drugs at damping down this inflammation to allow the damaged wall of the intestine to heal.

Antiinflammatory medication for ulcerative colitis

Relatively mild flare-ups of ulcerative colitis can be treated effectively using oral steroids such as prednisolone, which has good generalised anti-inflammatory activity. Steroids can only be taken in the short term - usually for 4-8 weeks - until other drugs such as mesalazine and azathioprine, which help control the over-active immune system, have a chance to take effect. Very powerful steroidal antiinflammatory drugs, notably dexamethasone, are particularly effective during flare ups of ulcerative colitis that affect the rectum. This can be particularly distressing but responds well to treatment with this potent steroidal anti-inflammatory drug.

Overcoming resistance to anti-inflammatory drugs

Over time, many patients with Crohn's disease and ulcerative colitis become resistant to the effects of anti-inflammatory drugs. New research is underway to find ways to overcome this. A very recent study looked at the possibility of introducing the steroidal antiinflammatory dexamethasone into the body bound to the patient's own red blood cells. This unusual approach proved quite effective, causing a remission of symptoms and reducing the need for oral anti-inflammatory drugs.

Avoiding colon surgery

Careful control of both Crohn's disease and ulcerative colitis using a combination of steroidal anti inflammatories and immune modulators can maintain remission. Patients are also encouraged to work with their diet to avoid foods rich in insoluble fibre and dairy fats, particularly during an acute phase of inflammation. This approach can help patients avoid severe complications such as a perforated or twisted bowel, which requires emergency surgery.

by: Jan Peterson

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