Ulcerative colitis medical therapy

Ulcerative colitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Ulcerative colitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Abdominal X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Alternative Treatments
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Ulcerative colitis medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Ulcerative colitis medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Ulcerative colitis medical therapy
CDC on Ulcerative colitis medical therapy
Ulcerative colitis medical therapy in the news
Blogs on Ulcerative colitis medical therapy
Directions to Hospitals Treating Ulcerative colitis
Risk calculators and risk factors for Ulcerative colitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

Main article: Treatment of ulcerative colitis

Main article: Biological therapy for inflammatory bowel disease

Standard treatment for ulcerative colitis depends on extent of involvement and disease severity. The goal is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse of the disease. The concept of induction of remission and maintenance of remission is very important. The medications used to induce and maintain a remission somewhat overlap, but the treatments are different. Physicians first direct treatment to inducing a remission which involves relief of symptoms and mucosal healing of the lining of the colon and then longer term treatment to maintain the remission.

Pharmacotherapies

Aminosalicylates

Sulfasalazine has been a major agent in the therapy of mild to moderate UC for over 50 years. In 1977 Mastan S.Kalsi et al determined that 5-aminosalicyclic acid (5-ASA and mesalazine) was the therapeutically active compound in sulfasalazine. Since then many 5-ASA compounds have been developed with the aim of maintaining efficacy but reducing the common side effects associated with the sulfapyridine moiety in sulfasalazine.

• Mesalazine, also known as 5-aminosalicylic acid, 5-ASA, Asacol, Pentasa and Mesalamine.
• Sulfasalazine, also known as Azulfidine.
• Balsalazide, also known as Colazal.
• Olsalazine, also known as Dipentum.

Corticosteroids

• Cortisone
• Prednisone
• Prednisolone
• Hydrocortisone
• Methylprednisolone
• Beclometasone
• Budesonide

Immunosuppressive drugs

• Mercaptopurine, also known as 6-Mercaptopurine, 6-MP and Purinethol.
• Azathioprine, also known as Imuran, Azasan or Azamun, which metabolizes to 6-MP.
• Methotrexate, which inhibits folic acid
• Tacrolimus

Biological treatment

• Infliximab
• Visilizumab

Contraindicated medications

Ulcerative colitis is considered an absolute contraindication to the use of the following medications:

• Alosetron
• Dicyclomine
• Glycopyrrolate
• Hyoscyamine
• Methscopolamine bromide
• Loperamide
• Reserpine
• Streptokinase