Whether we realize it or not, treatment options for both Crohn's Disease (CD) and Ulcerative Colitis (UC) have come a long way in the past 10, 20, and 30 years. Like me, my Dad has UC and when he was first diagnosed with it, options for treating the symptoms were scarce. He took Sulpha drugs after being hospitalized with a severe flare-up in the early ‘60s. And at the time of his hospitalization the doctors were so unsure of his long-term prognosis they told my mother to make sure "she had all of his papers in order, just in case." Not something my mother wanted to hear with my two older sisters at home just aged 3- and 4-years old.
Ten years ago when I was diagnosed with Colitis my father was upset and fearful for me. While he'd never missed a day of work in my whole lifetime I had always known he had "stomach issues," even if I never really understood what "issues those really were." I knew he spent a good amount of time in the bathroom, and that he always had a small box in his shirt pocket from which he would extricate these tiny white pills from time-to-time (Lomotil, essentially what allowed my dad to keep working and functioning).
At the time of my Dx in 1998 the 5-ASA drugs were the new kids on the block and I was extremely fortunate that the first drug I tried, Asacol, eventually helped to settle my gut. It took months of taking nine tablets per day (and making some major changes to my diet, lifestyle, and stress levels) before I was really able to see a perceptible difference. Over the years I have been able to get down to a maintenance dose recommended to me by my GI. But, I do have to admit that in the past couple of years I've tried to ‘wean' myself off of the Asacol altogether - but never without ending up in a flare within one week of beginning the experiment. I've now come to realize that the maintenance dose of Asacol is my friend and, as such, have decided it is in the best interest of my health to continue to take my maintenance dose.
Today, there are basically five categories or classifications of drugs to treat Crohn's Disease and/or Ulcerative Colitis.
- Aminosalycilates/5ASA drugs such as Asacol, Pentasa, Colazol, Dipentum, and Lialda - the newest drug approved to treat UC - all come in pill form and, Rowasa or Canasa come as enemas.
- Antibiotics - the two most commonly ones prescribed for IBD treatment are Flagyl and Cipro.
- Steroids like Prednisone, Hydrocortisone, and Endocort
- Immuno-Modulators include: Imuran, Purinethol, and Cyclosporine
- Biologics include Remicade (approved for CD and UC), Humira, (approved for CD), Tysabri (approved for CD only), and Cimzia (approved for CD only) - the newest Biologic which just came on the market in the past two weeks.
According to Dr. Edward Loftus, Jr. from the Mayo Clinic, Biologics are the newest class of drugs being produced to treat CD and UC. They are antibodies or antibody derivatives which are Biotechnically engineered molecules that are directed specifically against a particular substance in the inflammatory pathway.
Today, the 5-ASA drugs are usually the first line of treatment for people suffering from UC, while Antibiotics, Steroids, and Immuno-Modulators can be used both in CD and UC patients. And I've noted under the Biologics category which drug has been FDA approved for use in either CD or UC. It should be noted, however, that both Tysabri (approved in February 2008) and Cimzia (approved in April 2008) have been approved only for use in CD patients for whom other treatment options have failed. While promising treatment options for some CD patients, these new drugs can carry some potentially serious side effects and the potential use and side effects of either drug should be discussed thoroughly with your GI doctor.
If I had the choice, of course, I wouldn't have IBD, but, given that I do have UC I'm glad that there are so many new treatment options for treating it. And, if we all get involved in calling for further research and funding of research there's an even greater chance that more treatment options will become available, and more importantly, that one day in the near future the cause and cure for IBD will be found. Act today by writing to your Congressmen and Senators asking them to help fund further IBD research, or call the Crohn's and Colitis Foundation to find out what else you can do to put the IBD cause in the forefront of the medical and political communities.
Published On: May 07, 2008