[tri-med] Re: Karla - son's GI problems

Hi Karla,
It sounds like ulcerative colitis have they told you what they plan to do 
for treatment I just googled it and this is what I came up with:

Ulcerative colitis: treatment
Treatment of ulcerative colitis will depend on the severity of the disease 
and the effect the symptoms are having on your daily life. It will also 
depend upon whether you are in remission or are having an attack or flare-up 
of your disease.


Medications
  a.. Corticosteroids (also known as steroids)
  For flare-ups or relapses, steroids such as prednisolone are commonly used 
to reduce inflammation. Steroids may be given as tablets to be taken by 
mouth or as enemas, foams or suppositories to be put directly into the 
rectum. Mild attacks or attacks where only the rectum is involved are often 
treated with steroid enemas or rectal foam. If the inflammation is more 
severe or the colitis involves parts of the bowel which can't be reached 
with enemas or suppositories, then steroid tablets are often prescribed.

  If steroids are given for a long time, side-effects can occur, such as 
rounding of the face (moon face), mood changes, thinning of the bones 
(osteoporosis) and cataracts.

  If you have a severe attack of ulcerative colitis, you may be taken into 
hospital and be given intravenous steroids.

  b.. Aminosalicylates
  This kind of medication includes sulfasalazine (brand names Salazopyrin, 
Pyralin), mesalazine (Mesasal) and olsalazine (Dipentum). These medications 
have a similar structure to aspirin and are often used to prevent relapse. 
This is called maintenance treatment and it has been shown that people on 
maintenance therapy such as aminosalicylates often have fewer relapses 
(flare-ups) than other people. Although these medicines are mainly used as 
maintenance treatment they can help to control symptoms during an acute 
attack of the disease. Often your doctor will suggest you increase the dose 
during a flare-up.

  c.. Immunosuppressants
  Immunosuppressants are medications that suppress the activity of the body's 
immune system, such as azathioprine (for example, Imuran). They may be 
prescribed if your disease is not responding to steroids, or requires 
continuous steroids to control symptoms.


Other medications
Medications for diarrhoea and pain are also often prescribed.

Surgery
If maintenance medications don't help and you are still having flare-ups and 
the disease is seriously affecting your quality of life, or if your colon 
shows evidence of changes which your doctor believes could lead to cancer, 
then surgery may be recommended. However, only a minority of people with 
ulcerative colitis require surgery.
Depending on the extent of the disease, the surgery may involve removal of 
your colon (doctors call this colectomy) or both your colon and rectum 
(proctocolectomy).

  a.. Proctocolectomy with ileostomy
  If both your colon and rectum are removed the surgeon may perform an 
ileostomy where the ileum (the part of the intestine before the colon and 
rectum) will be made to discharge its contents out of the body through a 
hole in the abdomen. A bag will need to be worn outside the body to enable 
the drainage of waste.

  b.. Proctocolectomy with continent ileostomy
  This is a variation of the operation above. The colon and rectum are still 
removed, but the surgeon uses the ileum to construct a pouch inside the 
abdominal wall. There is a small opening in the person's side and 
periodically the person must insert a tube to empty the pouch.

  c.. Ileoanal anastomosis
  Alternatively, you may be able to have a different kind of operation that 
eliminates the need to use a bag altogether. A pouch is constructed from the 
end of the ileum and then attached directly to the anus, allowing you to 
expel your waste normally. However, this type of operation, which may be 
carried out in one or 2 stages, can result in frequent bowel movements in 
the long term.

Although the decision to have surgery will have to be carefully considered 
by you and your doctors, it does mean your condition should no longer be a 
problem.


How can I help myself?
Although doctors say there is no evidence ulcerative colitis is caused by 
food allergies, you may notice that some foods (particularly spicy or fatty 
foods or those which contain lots of fibre, such as fruits) make your 
symptoms worse. If so, you should avoid these. However, you should not 
restrict your intake of dietary fibre as a matter of course. Sometimes, 
though, people find that it helps their symptoms during a flare-up if they 
restrict their fibre intake.
Some people with ulcerative colitis lose weight and find it hard to maintain 
a healthy weight. Your doctor will advise you if you need to take 
nutritional supplements. Eating a healthy diet is very important if you have 
ulcerative colitis.

Blood loss in ulcerative colitis can lead to anaemia. If you become anaemic 
your doctor will probably recommend that you take iron tablets.

Although the disease can be disabling during flare-ups, people with 
ulcerative colitis are able to lead normal lives relatively free of symptoms 
during the times the disease is in remission. Medical treatment can greatly 
improve the quality of life for people with the condition, and research into 
new treatments is continuing all the time.




myDr, 2001
© Copyright: myDr, CMPMedica Australia, 2000-2009. All rights reserved.


Last Reviewed: 08 June 2006

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