Immunosuppressives such as 6-mercaptopurine have use in some patients. These agents are particularly effective for individuals who cannot be weaned off Prednisone. This medication has been used effectively in many patients. Its major side effect is that of bone marrow suppressants. Therefore, routine blood counts and office visits are required for individuals who are being treated with 6-mercaptopurine.
Cyclosporin, a strong immune suppressant, has also been utilized in limited patients who are severely ill with ulcerative colitis. This is best used under extremely controlled circumstances, usually in the hospital. Patients requiring IV Cyclosporin often require surgical intervention. A major side effect of Cyclosporin is nephrotoxicity. For this reason, Cyclosporin has limited use.
Complications associated with ulcerative colitis include toxic megacolon. Toxic megacolon is a condition where ulcerative colitis becomes out of control. The colon then becomes dilated. In this case, the colon may rupture causing peritonitis. Emergency surgery is required for treatment of toxic megacolon. In some patients IV Cyclosporin, under controlled circumstances, can be useful in order to provide a bridge for patients.
Other complications associated with this disease include colon cancer, dehydration, electrolyte abnormalities, infection and anemia.
Most patients should be examined for the development of colon cancer on a yearly basis with a colonoscopy. This allows for multiple biopsies to be obtained from the colon. Patients who have universal colitis have a 10 percent chance of developing colon cancer somewhere in the colon at the end of 10 years. Because of this, patients with universal colitis are instructed to have a colonoscopy on a yearly basis starting 8 years after their onset of symptoms. Should any evidence of abnormal cells be identified, a total colectomy is indicated.
After 10 years of therapy, the incidence of colon cancer rises for these patients at approximately 1 percent per year.
Patients with disease limited to the left side have been shown to have colon cancer develop at a later date (usually 15 years after the onset of symptoms). These individuals should be screened starting approximately 15 years after their initial symptoms.
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Other Gastrointestinal Diseases:
- Celiac Sprue |
Crohn's Disease |
Colon Cancer |
Colon Polyps |
Colorectal Cancer Screening Guidelines for 2001 |
Constipation |
Diarrhea |
Diverticulosis |
Esophageal Strictures |
Fecal Incontenence |
Gastrointestinal Bleeding |
GERD Treatment Guidelines Summary |
Helicobacter Pylori |
Hemorrhoids |
Irritable Bowel Syndrome |
Lactose Intolerance |
Malabsorption Syndromes |
Pancreatic Cancer |
Pancreatitis |
Pilonidal Cysts |
Puritis Ani |
Rectal Abscess |
Rectal Prolapse |
Treatment of Anal Fissures |
Ulcerative Colitis |
Whipple's Disease
Related Links
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Patient Education:
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