Ulcerative colitis : Ulcerative colitis is a chronic inflammation of the large intestine (colon). The colon is the part of the digestive system where water is removed from undigested material, and the remaining waste material is stored. The rectum is the end of the colon adjacent to the anus. In patients with ulcerative colitis, ulcers and inflammation of the inner lining of the colon lead to symptoms of abdominal pain, diarrhea, and rectal bleeding. Common symptoms of ulcerative colitis include rectal bleeding, abdominal pain, and diarrhea, but there is a wide range of symptoms among patients with this disease. Variability of symptoms reflects differences in the extent of disease (the amount of the colon and rectum that are inflamed) and the intensity of inflammation. Generally, patients with inflammation confined to the rectum and a short segment of the colon adjacent to the rectum have milder symptoms and a better prognosis than patients with more widespread inflammation of the colon.
Medication
Medications treating ulcerative colitis include 1) anti-inflammatory agents such as 5-ASA compounds, systemic corticosteroids, topical corticosteroids, and 2) immunomodulators.
Anti-inflammatory medications that decrease intestinal inflammation are analogous to arthritis medications that decrease joint inflammation (arthritis). The anti-inflammatory medications that are used in the treatment of ulcerative colitis are:
• Topical 5-ASA compounds such as sulfasalazine (Azulfidine),olsalazine (Dipentum), and mesalamine (Pentasa, Asacol, Lialda, Apriso Rowasa enema) that need direct contact with the inflamed tissue in order to be effective.
• Systemic anti-inflammatory medications such as corticosteroids that decrease inflammation throughout the body without direct contact with the inflamed tissue. Systemic corticosteroids have predictable side effects with long term use.
• immunomodulators include 6-mercaptopurine (6-MP), azathioprine (Imuran), methotrexate (Rheumatrex, Trexall), cyclosporine (Gengraf, Neoral).