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Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Drugs for Treatment of Diarrhea-Predominant IBS

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Diarrhea is characterized by the occurrence of frequent, watery bowel movements. Various factors can trigger diarrhea, including viral or bacterial infections, foodborne illnesses, side effects from certain medications, and underlying digestive disorders. If not adequately managed, diarrhea can lead to complications such as dehydration, electrolyte imbalances, and nutrient deficiencies. Severe diarrhea can lead to significant weight loss, malnutrition, and weakened immune function.
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Inflammatory Bowel Disease IV: Pharmacological Management

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Neoadjuvant therapy in rectal cancer.

Fergal J Fleming1, Lars Påhlman, John R T Monson

  • 1Division of Colorectal Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA. fergal_fleming@URMC.rochester.edu

Diseases of the Colon and Rectum
|June 10, 2011
PubMed
Summary

Neoadjuvant therapy for rectal cancer reduces local recurrence by 50% but increases complications by 50%. Accurate staging is crucial for optimizing treatment and patient selection in rectal cancer management.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastrointestinal Oncology

Background:

  • The optimal neoadjuvant therapy regimen for rectal cancer remains a subject of debate.
  • This review addresses the impact of neoadjuvant therapy on oncological outcomes and complications.

Purpose of the Study:

  • To evaluate the effects of neoadjuvant therapy on oncological outcomes and short- and long-term complications in rectal cancer patients undergoing total mesorectal excision.
  • To synthesize evidence from randomized controlled trials on neoadjuvant therapy for rectal cancer.

Main Methods:

  • Systematic review of 12 randomized controlled trials (RCTs) involving 9410 patients.
  • Electronic literature search of MEDLINE, PubMed, EMBASE, and Cochrane Database of Collected Reviews up to March 2010.
  • Key search terms included rectal cancer, total mesorectal excision, radiotherapy, and chemotherapy.

Main Results:

  • Neoadjuvant therapy (short-course radiotherapy or long-course chemoradiation) significantly reduces local recurrence by 50% in Stage II and III rectal cancer.
  • This benefit is associated with a 50% relative increase in acute treatment-related toxicity and long-term anorectal dysfunction.
  • Pathological complete response rates were also assessed as a key outcome measure.

Conclusions:

  • Accurate preoperative staging of rectal cancer is challenging, as the definitive tumor stage is determined histologically.
  • The current trade-off between reduced local recurrence and increased complications highlights the need for improved patient staging and precise neoadjuvant therapy delivery.
  • Further research is needed to refine patient selection and therapeutic strategies for neoadjuvant treatment in rectal cancer.