There are three ways to treat inflammatory bowel disease:
1. Self-Care at Home
It is important to eat a healthy diet. Depending on your symptoms, your health care provider may ask you to decrease the amount of fiber or dairy products in your diet.
Diet has little or no influence on the inflammatory activity in ulcerative colitis. However, diet may influence symptoms. For this reason, people with inflammatory bowel disease often are placed on a variety of diet interventions, especially low-residue diets. Evidence does not support a low-residue diet as beneficial in treating the inflammation of ulcerative colitis, though it might decrease the frequency of bowel movements.
Unlike ulcerative colitis, diet can influence inflammatory activity in Crohn disease. Nothing by mouth (NPO status) can hasten reduction of inflammation, as might the use of a liquid diet or a predigested formula.
When you become extremely upset, your symptoms may get worse. Therefore, it is important that you learn to manage the stress in your life.
2.Medical Treatment
The goal of medical treatment is to suppress the abnormal inflammatory response. This allows the intestinal tissue to heal, thereby relieving the symptoms of diarrhea and abdominal pain. Once the symptoms are under control, medical treatment is used to decrease the frequency of flare-ups and to maintain remission.
A stepwise approach to the use of medications for inflammatory bowel disease may be taken. With this approach, the most benign (least harmful) drugs or drugs taken for a short period of time are used first. If they fail to provide relief, drugs from a higher step are used.
The aminosalicylates and symptomatic agents are step I drugs under this scheme. Antibiotics are a step IA; they are particularly used in persons with Crohn disease who have perianal disease or an inflammatory mass.
Corticosteroids constitute step II drugs to be used if the step I drugs fail to provide adequate control of the IBD. They tend to provide rapid relief of symptoms as well as a significant decrease in inflammation.
The immune modifying agents are step III drugs to be used if corticosteroids fail or are required for prolonged periods. These agents are not used in acute flare-ups because the time from initiation of treatment to the onset of significant action may be as long as 2-3 months. Infliximab is a step IIIA drug to be used in persons with Crohn disease. As of this writing, the medications approved by the US FDA for the treatment of Crohn disease are prednisone, budesonide, and infliximab.
The experimental agents are step IV drugs to be used only after failure of the previous steps and only by health care providers familiar with their use.
Note that drugs from all steps may be used additively; in general, the goal is to wean off the corticosteroids as soon as possible to prevent long-term side effects. There may be different opinions regarding the use of certain agents in this stepwise approach.
3.Surgery
Surgical treatment in persons with inflammatory bowel disease varies, depending upon the disease. Ulcerative colitis is a surgically curable disease because the disease is limited to the colon. However, surgical resection is not curative in persons with Crohn disease. On the contrary, excessive surgical intervention in persons with Crohn disease can lead to more problems. Situations arise in Crohn disease in which surgery without resection can be used. This is done to halt function of the colon in order possibly to allow for healing of the disease distal to the site where surgery is done.
Ulcerative colitis
- In about 25-30% of persons with ulcerative colitis, medical treatment is not completely successful. In such persons and in persons with dysplasia (changes in the cells that are considered a precursor to cancer), surgery may be considered. Unlike Crohn disease, which can recur after surgery, ulcerative colitis is cured after colectomy (surgical removal of the colon).
- The surgical options for persons with ulcerative colitis depend on a number of factors: the extent of the disease, the person's age, and his overall health. The first option involves the removal of the entire colon and rectum (proctocolectomy) with the creation of an opening on the abdomen through which feces is emptied into a pouch (ileostomy). This pouch is attached to the skin with an adhesive.
- The other most commonly used option is a technically demanding surgery and is generally a multistage procedure. The surgeon removes the colon, creates an internal ileal pouch from the small intestine, attaches it to the anal sphincter muscle (ileoanal anastomosis), and creates a temporary ileostomy. After the ileoanal anastomosis heals, the ileostomy is closed and the passage of the feces through the anus is reestablished.
Crohn disease
- Even though surgery is not curative in persons with Crohn disease, approximately 75% of persons will require surgery at some point of time (especially for complications). The most simple surgery for Crohn disease is the segmental resection, in which a segment of intestine with active disease or a stricture (narrowing) is removed and the remaining bowel is reanastomosed (two ends of healthy bowel are joined together).
- In persons with a very short stricture, instead of removal of that part of the intestine, a bowel-sparing stricturoplasty (repair) can be performed.
- Ileorectal or ileocolonic anastomosis is an option is some persons who have lower small intestine or upper colon disease.
- In persons with severe perianal fistulae, diverting ileostomy/colostomy is a surgical option. In this procedure, the function is halted for the distal colon and a temporary ileostomy or colostomy is created. The rectum, for which function is halted, is allowed to heal, and the ileostomy/colostomy is then reversed.
More information about inflammatory bowel disease:
 Inflammatory bowel disease overview Inflammatory bowel disease is a name given to a group of chronic digestive diseases of the small and large intestines. Your doctor may refer to your particular condition by any one of several terms, including colitis, proctitis, enteritis and ileitis.
The Cause of Inflammatory bowel disease Genetic, infectious, immunologic, and psychological factors have all been implicated in influencing the development of IBD.
The Symptoms of Inflammatory bowel disease The most common symptoms of IBD are diarrhea and abdominal pain. Ulcerative colitis usually causes rectal bleeding, as well. Crohn's disease also may cause rectal bleeding, but less often than does ulcerative colitis.
Treatment for Inflammatory bowel disease There are three ways to treat inflammatory bowel disease, 1. Self-care at home, 2. Medical Treatment, 3. Surgery
Inflammatory bowel disease prevention
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