Ulcerative Colitis: Inflammatory Bowel Disease

Description

Alternative Names

Symptom Management

Diarrhea and Constipation

The following are some ways of managing diarrhea, constipation, or both:

• Mild to moderate diarrhea may be reduced by taking one teaspoon of psyllium hydrophilic colloid (Metamucil) twice a day in a glass of water.
• Anti-diarrhea drugs include loperamide (Imodium) and Lomotil. In very ill patients, large doses of some drugs, such as Lomotil, can trigger the onset of toxic megacolon.
• Opiates or drugs used to relax muscle spasms may help relieve mild to moderate diarrhea and abdominal cramps, but they should be used for very short periods and not for severe cases.
• Bulk-type laxatives can help constipation.

Treating Anemia

Iron supplements may be required for anemia. Intravenous iron with or without erythropoietin (a hormone that acts in the bone marrow to increase the production of red blood cells) is effective for severe anemia in IBD that does not respond to iron alone. Crohn's disease patients benefit from the combination; ulcerative colitis patients usually improve on IV iron alone.

Antidepressants

Antidepressants may help relieve emotional problems. However, inflammatory bowel disease is not a psychologic disorder, and such drugs will not affect the basic illness.

Pain-Relievers

Acetaminophen, sold as Tylenol and other common brands, is the drug of choice for mild pain. Acetaminophen is not one of the nonsteroidal anti-inflammatory drugs (NSAIDs), which include, among dozens of others, aspirin, ibuprofen (Advil, Motrin, Rufen), and naproxen (Anaprox, Naprosyn, Aleve). NSAIDs are often used against other inflammatory disorders, but they have been implicated in triggering inflammatory bowel disease; one study found that they doubled the risk for emergency treatment of gastrointestinal symptoms in patients with colitis. NSAIDs, therefore, should be avoided for IBD.

Stress Reduction

Although stress is not a cause of inflammatory bowel disease, there are reports of an association between stress and symptom flare-ups. Patients with IBD, in fact, may have a more exaggerated physical response to stressful events than people without IBD. Although no evidence exists to confirm that stress reduction techniques, such as relaxation methods, meditation, or cognitive therapy, manage the disease, they might be helpful.

Alternative Remedies

Castor Oil Pack. Some ulcerative colitis patients report relief from the use of a castor oil pack for three consecutive days. The oil is applied directly to the skin and then covered with a clean soft cloth and plastic wrap. A hot water bottle or heating pad is then placed over the pack for 30 to 60 minutes.

Acupuncture. Acupuncture may help relieve symptoms in some patients.

Melatonin. Melatonin is a hormone found in the brain that is best known for its role in sleep. Researchers have also observed that gastrointestinal tract is also rich in melatonin, and that the hormone may have properties that reduce acid secretion and improve blood flow. Some researchers believe that it warrants investigation for ulcerative colitis and other intestinal and stomach problems. It should be stressed that melatonin is currently classified as a dietary supplement and not as a drug, so its quality and effectiveness is uncontrolled in the US. (The United States is the only developed nation that does not regulate this agent.) The bottom line is that at this time, people who take melatonin are experimenting on themselves.