- I talk to Dr. Wade this morning , they are going to do a colonoscopy on Monday morning. Test results came in last night from the Cat Scan. Grandma Colon on the left inside is inflamed and aggravated. At this time the Dr. is trying to narrow down the cause for colitis there 4 causes, I have look up 3 main definitions to help you understand. The Fourth cause is bacterial infection Treatment is antibiotics. Grandma does have a urine infection which they are treating. Grandma is being moved to the 9th floor Room 934. She is not contagious and dose not need a private room. I will be visiting Grandm this afternoon. The Dr said Grandma is talking about Grandad, how they met, the Brown Palace and Grandad working in Alaska on the highway to bring oil to our troops during WII. She is eating a little bit more and is on a liquid diet.
- Ulcerative colitis (Colitis ulcerosa, UC)
is a form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon, that includes characteristic ulcers, or open sores, in the colon. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset. Because of the name, IBD is often confused with irritable bowel syndrome (“IBS“), a troublesome, but much less serious, condition. Ulcerative colitis has similarities to Crohn’s disease, another form of IBD. Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Although the symptoms of ulcerative colitis can sometimes diminish on their own, the disease usually requires treatment to go into remission.
Ulcerative colitis occurs in 35–100 people for every 100,000 in the United States,[1] or less than 0.1% of the population. The disease is more prevalent in northern countries of the world, as well as in northern areas of individual countries or other regions. Although ulcerative colitis has no known cause, there is a presumed genetic component to susceptibility. The disease may be triggered in a susceptible person by environmental factors. Although dietary modification may reduce the discomfort of a person with the disease, ulcerative colitis is not thought to be caused by dietary factors. Although ulcerative colitis is treated as though it were an autoimmune disease, there is no consensus that it is such. Treatment is with anti-inflammatory drugs, immunosuppression, and biological therapy targeting specific components of the immune response. Colectomy (partial or total removal of the large bowel through surgery) is occasionally necessary, and is considered to be a cure for the disease.
2. Collagenous colitis
is an inflammatory colonic disease with peak incidence in the 5th decade of life, affecting women more than men. Its clinical presentation involves watery diarrhea, usually in the absence of rectal bleeding. It is often classified under the umbrella entity microscopic colitis, along with a related condition, lymphocytic colitis.
Diagnosis
On colonoscopy, the mucosa of the colon typically looks normal, but biopsies of affected tissue usually show deposition of collagen in the lamina propria, which is the area of connective tissue between colonic glands. Radiological tests, such as a barium enema are typically normal.
Causes
The exact cause of collagenous colitis is unknown, but the effects of non-steroidal anti-inflammatory drugs such as diclofenac are commonly implicated.[citation needed] The other group of agents most commonly associated with collagenous colitis are the selective serotonin reuptake inhibitors used in the treatment of depression.
Treatment
Standard treatment for ulcerative colitis depends on extent of involvement and disease severity. The goal is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse of the disease. The concept of induction of remission and maintenance of remission is very important. The medications used to induce and maintain a remission somewhat overlap, but the treatments are different. Physicians first direct treatment to inducing a remission which involves relief of symptoms and mucosal healing of the lining of the colon and then longer term treatment to maintain the remission.
Drugs used
Aminosalicylates
Sulfasalazine has been a major agent in the therapy of mild to moderate UC for over 50 years. In 1977 Mastan S. Kalsi et al. determined that 5-aminosalicylic acid (5-ASA and mesalazine) was the therapeutically active compound in sulfasalazine. Since then many 5-ASA compounds have been developed with the aim of maintaining efficacy but reducing the common side effects associated with the sulfapyridine moiety in sulfasalazine.[35]
- Mesalazine, also known as 5-aminosalicylic acid, mesalamine, or 5-ASA. Brand name formulations include Apriso, Asacol, Pentasa, Mezavant, Lialda, and Salofalk.
- Sulfasalazine, also known as Azulfidine.
- Balsalazide, also known as Colazal or Colazide (UK).
- Olsalazine, also known as Dipentum.
Corticosteroids
Immunosuppressive drugs
- Mercaptopurine, also known as 6-Mercaptopurine, 6-MP and Purinethol.
- Azathioprine, also known as Imuran, Azasan or Azamun, which metabolises to 6-MP.
- Methotrexate, which inhibits folic acid
- Tacrolimus
- Thioguanine, Also known as Lanvis and usually given to cancer patients
- Biological treatment
- Infliximab, also known as Remicade.
- Visilizumab
- Adalimumab, also known as HUMIRA.[22]
- Vedolizumab (MLN0002), currently under testing by Millennium Pharmaceuticals[36]
of the large intestine, also known as a colectomy. This procedure is necessary in the event of: exsanguinating hemorrhage, frank perforation or documented or strongly suspected carcinoma. Surgery is also indicated for patients with severe colitis or toxic megacolon. Patients with symptoms that are disabling and do not respond to drugs may wish to consider whether surgery would improve the quality of life.
3. Ischemic colitis
From Wikipedia, the free encyclopedia
- This article concerns ischemia of the large bowel. See mesenteric ischemia for ischemia of small bowel
Ischemic colitis (ischaemic colitis in British English) is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia.[1][2][3] Causes of the reduced blood flow can include changes in the systemic circulation (e.g. low blood pressure) or local factors such as constriction of blood vessels or a blood clot. In most cases, no specific cause can be identified.[4]
Ischemic colitis is usually suspected on the basis of the clinical setting, physical examination, and laboratory test results; the diagnosis can be confirmed via endoscopy or by using sigmoid or endoscopic placement of a visible light spectroscopic catheter (see Diagnosis). Ischemic colitis can span a wide spectrum of severity; most patients are treated supportively and recover fully, while a minority with very severe ischemia may develop sepsis and become critically ill.[5]
Patients with mild to moderate ischemic colitis are usually treated with IV fluids, analgesia, and bowel rest (that is, no food or water by mouth) until the symptoms resolve. Those with severe ischemia who develop complications such as sepsis, intestinal gangrene, or bowel perforation may require more aggressive interventions such as surgery and intensive care. Most patients make a full recovery; occasionally, after severe ischemia, patients may develop long-term complications such as a stricture[6] or chronic colitis.[7
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