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INFLAMMATORY BOWEL DISEASE

Ulcerative colitis and Crohn's Disease Contd....

About the author

Dr. Minocha (http://www.diagnosishealth.com/minocha.htm) is the Professor of Medicine and Director, Division of Digestive Diseases at the University of Mississippi Medical Center in Jackson, MS, and is the author of How to Stop Heartburn; Simple Ways to Heal Heartburn and Acid Reflux.

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In patients requiring long-term steroids, immuno-suppressive agents like imuran and 6-MP are helpful in reducing the required dose of steroids. However, these drugs may take several months to manifest their action.
Several other drugs are used on occasion. Metronidazole (Flagyl) is useful in Crohn's disease. Cyclosporine is useful in acutely severe situations. Nicotine is helpful in acute ulcerative colitis. Preliminary results on the use of blood thinner, heparin, are promising. Methotrexate is being investigated.

Infliximab (Remicade) is an exciting new addition. It is a monoclonal antibody against tumor necrosis factor alfa. It is given as a single iv infusion of 5mg/kg over 2 hours for moderate to severe active Crohn's disease unresponsive to conventional treatment. In cases of fistulizing Crohn's disease, the initial dose is repeated at 2 and 6 weeks. Side effects: infections, lupus like syndrome, Infusion related reaction, digestive upset.

Both ulcerative Colitis and Crohn's disease may affect organs other than the bowel, including skin, liver, gall bladder, joints, kidneys and eyes etc.

Surgery can cure Ulcerative Colitis. Newer surgeries obviate the need for ileostomy. There is no known cure for Crohn's disease although these patients may need frequent surgeries.

Both Ulcerative Colitis and Crohn's Disease increase the risk for cancer. The risk for cancer of colon depends on the extent and duration of Ulcerative Colitis. Surveillance colonoscopies are recommended for Inflammatory Bowel Disease.

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RELATED PUBLICATIONS BY DR. MINOCHA.....

1. Minocha et al. Acute Sulfasalazine Overdose. Journal of Toxicology Clinical Toxicolgy 1991.

2. Minocha et al. Small Bowel Endometriosis Masquerading as Regional Enteritis. Digestive Diseases and Sciences 1994.

3. Minocha et al. Lack Of Crucial Role of Mast Cells in Pathogenesis of Experimental Colitis in Mice. Digestive Diseases and Sciences 1995.

4. Minocha A et al.: Crohn's Disease Complicating Male Genitourinary Tract Without Overlying Cutaneous Involvement. Am J Gastroenterol 1996.

5. Minocha A et al.: Role of Appendectomy and Tonsillectomy in Pathogenesis of Ulcerative Colitis. Digestive Diseases And Sciences 1997.

This is an informational exercise. Your doctor is the only one who can best assess your situation and offer you medical advice.

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