Treatment for ulcerative colitis differs based on the individual. Where the inflammation occurs, the severity, and the preference of the patient can all influence the treatment. For those with moderate to severe ulcerative colitis, biologics are an option. This type of medication has proven to be effective in reaching and maintaining remission. It works differently than past medications for this condition, as they are protein-based and operate like antibodies. Biologics are not typically the first option for treatment, as people tend to go through treatment of 5-aminosalicylic acids, but they offer another option if this medication fails. This new option has shown to be effective, but it is important to remember to talk with your doctor to ensure that biologics are the best method for you.
About Ulcerative Colitis
Ulcerative colitis falls under a group of disorders called inflammatory bowel disease (IBD). It is characterized by the inflammation of the digestive tract, specifically sores and ulcers in the large intestine. People who have a family history of IBD, are young adults or over the age of 60, or are of Ashkenazi Jewish heritage are at a higher risk of having this condition. It is estimated that 700,000 people in the United States have ulcerative colitis.
Common symptoms of ulcerative colitis include blood in the stool, loose bowel movements, fatigue, weight loss, nausea, anemia, cramping, joint pain, and rashes. Medical professionals are unaware of the exact cause of this condition, but they expect that an immune system malfunction and genetic components play a role.
There is no cure for ulcerative colitis, but patients can achieve remission and experience minimal symptoms. The common treatments for this condition are antibiotics, aminosalicylates, corticosteroids, immunomodulators, and biologics.
Biologics are protein-based medications, and they work like antibodies. They block proteins that cause the inflammation that characterizes ulcerative colitis. There are three types of biologics that are currently approved by the FDA: anti-tumor necrosis factors (TNF) agents, anti-integrins, and ustekinumab. They work to stop the inflammation, heal damage, and stop symptoms like excessive bowel movements, pain, and blood in the stool.
Biologics are for those who have moderate to severe ulcerative colitis, and they are typically used after other treatments fail. Unless there is a serious impact on the quality of life, biologics are not the first step in treatment. Because they are a long-term treatment, it is highly recommended that patients speak with a doctor and ensure that biologics are right for them.
Biologics are administered through an injection that can be done at home or an infusion done at an infusion center. People will need to inject every two-eight weeks. In order to tell if the treatment is effective, doctors will do one of three things. They will look for clinical remission, endoscopic remission, or steroid independence. Remission is the goal of biologics, but it can take different amounts of time to achieve for different people. Some see remission in eight weeks, but in others it will take longer.
Even if remission is achieved, discontinuing treatment is not always the best option. Stopping and starting on these medications is not recommended, as the body can develop antibodies to the biologics. If this happens, treatment becomes ineffective.
There are some side effects that may come with this treatment. It is necessary that patients are tested for tuberculosis and hepatitis B, as biologics has the potential to reactive dormant strains of these diseases. Other side effects include headaches, fever, chills, hives, and rashes. Rarer side effects are infections, arthritis, and lupus-like reactions.
Overall, having a discussion with your doctor on treatment is very important. Biologics have shown to be very effective, but everyone should ensure that this treatment is the best choice for them. An open conversation with a doctor throughout treatment about side effects and symptoms is integral.
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