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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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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...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Drugs for Treatment of Diarrhea-Predominant IBS01:17

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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Severe ulcerative colitis: predictors of response and algorithm proposal for rescue therapy.

D G Ribaldone1,2, I Dileo3, R Pellicano3

  • 1Gastroenterology-U, General and Specialist Medicine Department, Città della Salute e della Scienza of Turin, C.so Bramante 88, 10126, Turin, Italy. davrib_1998@yahoo.com.

Irish Journal of Medical Science
|July 31, 2017
PubMed
Summary

This study identifies predictors for rescue therapy response in severe ulcerative colitis. Cyclosporine A is recommended for ex-smokers, while infliximab or cyclosporine A choice depends on Mayo score and CRP levels in smokers.

Keywords:
Anti-TNFCyclosporineInfliximabRescue therapyUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Immunology
  • Pharmacology

Background:

  • Severe steroid-refractory ulcerative colitis (UC) treatment efficacy is debated.
  • Predicting response to rescue therapies like infliximab and cyclosporine A is crucial for patient management.

Purpose of the Study:

  • To identify predictors of treatment response to infliximab and cyclosporine A in severe UC.
  • To guide therapeutic decisions for patients with severe UC.

Main Methods:

  • Cross-sectional study including 49 patients with severe UC.
  • Response defined as >=3 point reduction in Mayo score after 6 months and colectomy avoidance after 1 year.
  • Analyzed predictors: gender, age, disease duration, prior steroid/azathioprine use, smoking, disease extent, labs, and Mayo score.

Main Results:

  • Infliximab responders had moderate Mayo scores (P=0.04); ex-smokers showed low response (P=0.03).
  • Cyclosporine A responders had C-reactive protein (CRP) >3 mg/L (P=0.03).
  • Elevated CRP and/or severe Mayo score predicted better cyclosporine A response (15 vs 4, P=0.008).

Conclusions:

  • Cyclosporine A is suggested for ex-smokers.
  • For never/active smokers, infliximab is recommended for Mayo score <=10 and/or negative CRP.
  • Cyclosporine A is indicated for Mayo score >10 and positive CRP in smokers.