Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Treatments
A. In conventional medicine perspective
Iatrogenic colitis
A.3.1. Diversion colitis
1. Short-chain-fatty acid irrigation
A condition known as diversion colitis frequently develops in segments of the colorectum after surgical diversion of the fecal stream. In the study of four patients with diversion colitis, none of whom had evidence of Crohn's, idiopathic ulcerative, or infectious colitis, found that diversion colitis
may represent an inflammatory state resulting from a nutritional
deficiency in the lumen of the colonic epithelium, which is effectively
treated by local application of short-chain fatty acids, the missing
nutrients(86a).
2. 5-aminosalicylic acid (Rowasa) enemas
a. There is a report of an 85-yr-old female presented with diversion colitis after surgery with a resultant colostomy and excluded rectal segment. Treatment with 5-aminosalicylic acid (Rowasa) enemas resulted in both endoscopic and histological resolution. This is the first case of diversion colitis treated with 5-aminosalicylic acid enemas, according to the study by Winthrop University Hospital(86b).
b. Side effects are not limit to severe stomach pain, cramping, fever, headache, and bloody diarrhea
3. Corticosteroids
a. According to the study by, Short-term corticosteroid use is associated with generally mild side effects, including cutaneous effects, electrolyte abnormalities, hypertension, hyperglycemia, pancreatitis, hematologic, immunologic, and neuropsychologic effects, although occasionally, clinically significant side effects
may occur. Long-term corticosteroid use may be associated with more
serious sequel, including osteoporosis, aseptic joint necrosis, adrenal
insufficiency, gastrointestinal, hepatic, and ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital malformations(81a).
b. Side effects, According to the study by, Short-term corticosteroid use is associated with generally mild side effects, including cutaneous effects, electrolyte abnormalities, hypertension, hyperglycemia, pancreatitis, hematologic, immunologic, and neuropsychologic effects, although occasionally, clinically significant side effects
may occur. Long-term corticosteroid use may be associated with more
serious sequel, including osteoporosis, aseptic joint necrosis, adrenal
insufficiency, gastrointestinal, hepatic, and ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital malformations(81a)
4. Surgery
a. Colectomy
Colectomy is a surgical treatment in
removing the colon. In the study using the University of Manitoba
Inflammatory Bowel Disease Epidemiology Database, a population-based
data set including UC patients with up to 25 years of post diagnosis
follow-up, found that the cumulative incidence of colectomy
in UC is lower than previously reported, and appears to be decreasing
further among more recently diagnosed cohorts of patients. Male sex and
hospitalization at the time of diagnosis are major risk factors for EC
and LC(83)
But according to the study by Division of
Gastroenterology and Hepatology, Mayo Clinic, patients with moderately
to severely active ulcerative colitis treated with infliximab were less likely to undergo colectomy through 54 weeks than those receiving placebo(84).
b. Proctocolectomy and Ileostomy
Proctocolectomy
is a surgical procedure to remove the entire colon and rectum.
Ileostomy is a surgical opening constructed by bringing the end or loop
of small intestine (the ileum) out onto the surface of the skin(85).
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Sources
(81) http://www.ncbi.nlm.nih.gov/pubmed/22767007
(81a) http://www.ncbi.nlm.nih.gov/pubmed/11588541
(82) http://www.ncbi.nlm.nih.gov/pubmed/23034604
(83) http://www.ncbi.nlm.nih.gov/pubmed/22613902
(84) http://www.ncbi.nlm.nih.gov/pubmed/19596014
(85) http://en.wikipedia.org/wiki/Ileostomy
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