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Category Archives: Ulcerative Colitis
Posted: September 2, 2017 at 7:42 am
By Gerry Fraley , Staff Writer Contact Gerry Fraley on Twitter:
ARLINGTON – Rangers left-hander Jake Diekman made a storybook return to the Rangers’ bullpen on Friday night.
Diekman, making his first appearance of the season, entered to a rousing reception from the spectators at Globe Life Park. He departed to a standing ovation after a scoreless inning during a 10-9 win against the Los Angeles Angels at Globe Life Park.
Diekman soaked in the crowd response as he ran in from the bullpen during the seventh inning. He came off the field to a standing ovation after retiring all three hitters while performing his specialty: holding a lead.
“I wanted to notice if it was there,” Diekman said of the response to his appearance. “The fans, that was amazing. I just wanted to run toward the mound.”
Diekman spent the first five months of the season on the disabled list while undergoing three surgeries for ulcerative colitis. Manager Jeff Banister had hoped to bring Diekman into a low-stress situation for his first appearance but did not have that luxury.
With Jose Leclerc unavailable after working two innings Thursday, Banister went to Diekman after Ricky Rodriguez faced four hitters without getting an out in the seventh. The Rangers’ lead was down to 9-6.
The moment turned into high drama when Diekman retired all three hitters faced, allowing an inherited runner to score on a sacrifice fly. When Diekman returned to the dugout, he was overcome by emotion. He tried to hide the reaction by burying his face in a towel, but that fooled no one.
“To be able to hand the ball off to him in one of the highest leverage situations we’ve had all year, for him to get the third out was a tremendous effort by Jake,” Banister said. “Every one of our players couldn’t wait to see him.”
Diekman was among four players added on the first day of expanded rosters. The Rangers also added catcher A.J. Jimenez, third baseman Will Middlebrooks and right-hander Paolo Espino. The club expects to add a few more players next week, after Triple-A Round Rock’s season ends.
The goal of returning to the mound drove Diekman through his recovery from the surgeries.
“It’s been a long road,” Diekman said. “Very, very excited to get back out there.”
Without Diekman, the bullpen has been ineffective in late-game situations. In 2016, Diekman led the club with 26 ”holds,” preserved save chances, in 27 opportunities. Leclerc leads the Rangers in “holds” this season with 10.
“When you think about the instability in the bullpen this year, it would have been really nice to have had him out there,” Banister said. “It’s been a challenge without him.”
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Texas Rangers: After 3 surgeries and 5-month DL stay, Rangers … – Dallas News (blog)
Asthma Is Associated with Subsequent Development of Inflammatory Bowel Disease, Study Shows – Lung Disease News
Posted: September 1, 2017 at 6:51 pm
A population-based study found an association betweenasthma andthe subsequent development of inflammatory bowel disease (IBD).
Using health databases fromAlberta, Canada, the study examined 5,464 IBD patients (3,087 with Crohns disease and 2,377 with ulcerative colitis) and 402,800 controls. Researchers then looked at previous diagnosis of asthma in each of these groups.
Results showed that there was a statistically significant chance of developing Crohns disease in patients previously diagnosed with asthma, regardless of the age at diagnosis of Crohns.
Previous diagnosis with asthma was also significantly associated with the development of ulcerative colitis, but only in individuals diagnosed with ulcerative colitis before the age of 16 (3-16) and over the age of 40. There was no association between asthma and ulcerative colitis among individuals diagnosed between ages 17 and 40.
Taken together, these results indicate that patients with asthma are at a higher risk of developing Crohns disease, and early and late onset ulcerative colitis.
The study Asthma is Associated With Subsequent Development of Inflammatory Bowel Disease: A Population-Based Case-Control Study was published in the journal Clinical Gastroenterology and Hepatology.
The researchers built on previous studies that showed there is an association between IBD and respiratory disorders, including asthma. Since asthma is usually diagnosed at an earlier stage than IBD, the researchers hypothesized that there is an association between asthma and the subsequent IBD diagnosis including Crohns disease and ulcerative colitis later in life.
Although the mechanisms that led to the observed association betweenasthma and IBD in the study are unknown, similarities in the underlying structure of lung and intestinal tissues are thought to play a role.
The results of the study suggest that there are differences in IBD pathogenesis according to age and gender. Women were found to be more likely to develop Crohns disease, while thoseover age 40 had a lower chance of developing ulcerative colitis compared with age-matched men.
The authors point out a few limitations of their study, such as the examined databases not containing enough data regarding so-called unmeasured confounders, such as smoking.
The team emphasizes thatamong theclinical implications of their study is that it may serve as a red flag to help identify patients presenting with chronic gastrointestinal symptoms that may benefit from priority early referrals to gastroenterologists.
They conclude by saying that future studies are necessary to determine the mechanisms through which asthma and IBD are related.
Posted: at 5:50 am
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Valtrex rxlist – Low dose valtrex for cold sores – Forward Florida
Posted: August 30, 2017 at 8:49 am
Fortunately, there is a wide range of treatment options available that can help control ulcerative colitis (UC) as long as you stay on your treatment as prescribed. Getting ulcerative colitis under control and achieving remission (few or no symptoms) is a main goal of ulcerative colitis treatment.
Often, the time with your doctor may be limited, so make it a priority to talk to your doctor about what you can expect from treatment and whether your treatment plan is working for you at every check-up. Talk to your doctor about finding a treatment that can help you reach these goals:
Remember, if you still experience a flare-up of symptoms and are taking your treatment as prescribed, you may want to talk to your doctor about whether your treatment is right for you. Your doctor may reassess your medication depending on the severity of your symptoms (whether they are mild, moderate, or severe).
Gastroenterologist Dr. Millie Long discusses treatment options and the importance of setting treatment goals.
Millie Long, M.D., M.P.H., is an Associate Professor at the University of North Carolina Chapel Hill School of Medicine.
Using this information, along with certain other tests and additional information, your doctor can help develop a treatment plan that works for you.
Medications that treat ulcerative colitis strive to control the inflammation that is a main cause of UC symptoms and induce remission. Its quite possible that you may try multiple medications before finding the one that works best. So talk to your doctor if you feel like your medication isnt meeting your treatment goals.
Its also important to note that the medication your doctor prescribes may depend on whether you have mild, moderate, or severe UC and/or where in your large intestine your disease is active.
Depending on your ulcerative colitis symptoms, your doctor may recommend over-the-counter (OTC) medications for you, such as:
Over-the-counter medications are often suggested to be taken as a supplement to your prescriptionnot instead of it.
You may also be familiar with natural medicinealternative treatments, therapies, or medicine to supplement or use in place of prescription medications. Make sure you have an honest dialogue with your doctor before using alternative treatments, as they can impact the effects of traditional therapies.
Treatment with medication is the first therapeutic option for people with ulcerative colitis. However, surgery may be a consideration if the disease doesnt respond to medicationand surgery is sometimes considered to be a cure in ulcerative colitis.
Surgery in ulcerative colitis usually involves removal of the colon and rectum, which is called a proctocolectomySurgical procedure involving removal of the rectum and/or colon. The procedure can include all or part of the colon., of which the following variations are possible:
Total proctocolectomy with end ileostomyA total proctocolectomy is when the anus is surgically removed in addition to the colon and rectum. An ileostomy is a surgical procedure that creates a hole in the abdomen (called a stoma) through which solid waste is emptied into a pouch.
Proctocolectomy with ileal pouch-anal anastomosis (IPAA) In this procedure, the colon and the rectum are removed, but the anus and anal sphincter muscles are preserved. The ileum is fashioned into a J, S, or W shaped pouch. This eliminates the need to wear a permanent external bag.
Its important to keep in mind that ulcerative colitis can still cause symptoms after surgeryso it’s essential to continue to work with your doctor to keep up with the management of your disease.
Find out about a treatment option for moderate to severe ulcerative colitis. Learn more.
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Ulcerative Colitis Treatment & Medication Options
Posted: at 8:49 am
WHAT IS ULCERATIVE COLITIS?
Ulcerative colitis (UC) is an inflammatory disease potentially affecting the entire large bowel (colon and rectum). The inflammation is confined to the innermost layer of the intestinal wall (mucosa). UC can go into remission and recur. Medical management is typically the first option for treatment. If surgery is needed for UC, it is usually curative.
Men and women are affected equally and people of all ages can develop UC. A family history of UC slightly increases the risk of the disease.
The exact cause of UC is unknown, but it is not contagious. Potential causes include immune system abnormalities and bacterial infection.
Most patients develop symptoms in their 40s. A smaller number experience symptoms for the first time later in life (ages 60 to 70). The symptoms of UC are similar to Crohns disease, when the latter only affects the colon and rectum. The most common symptoms of UC include:
The first step is to undergo a thorough medical history and physical exam. Following this, additional testing may be needed. This may include blood tests, a complete colonoscopy of the rectum, colon and terminal ileum (the end of the small intestine that intersects with the large intestine), as well as x-rays. This evaluation helps determine the extent and severity of UC, rules out other diseases such as Crohns disease, and guides management.
Medical treatment is always the first choice unless emergency surgery is required. The goal of medical therapy is to improve a patient’s quality of life. Initially, the most common therapy is corticosteroids (steroid hormones) combined with anti-inflammatory agents. Based on the extent of the disease, these are taken orally or as a rectal suppository.
Surgery is considered for patients when medical management is no longer effective. Other reasons that a patient may require surgery include cancer or precancerous lesions that are found during colonoscopy. Sometimes surgery needs to be performed when a complication of the disease occurs such as a perforated bowel (hole in the bowel), severe bleeding or serious infection (toxic colitis).
Since UC involves only the colon and rectum, complete removal of both may be done in some cases. This treatment option is curative, but requires an ileostomy. Some patients may be candidates for a J-pouch. This procedure involves the removal of the entire colon and all of the rectum with the exception of the last section where the sphincter muscles are located. The small bowel is then used to create a new rectum (the pouch) which is attached just above the sphincter muscles. The patient will have a temporary ileostomy during the healing period however ultimately this will be taken down and the patient will be able to pass stool through their anus again.
Elective and emergency surgeries can be performed through traditional open procedures or minimally invasive (laparoscopic) approaches depending on the circumstances. The safest, most effective approach is determined on an individual basis.
Because emergency surgery is done for potentially life threatening conditions, it is most often done as an open procedure.During emergency surgery, the large bowel (colon) is removed. The rectum and anus are left in place temporarily. The end of the small bowel (ileum) is brought out through the abdominal wall to the skin level. An ileostomy is created through which fecal matter is allowed to empty into a bag attached to the skin.
After recovery, a second procedure can be performed. During this surgery, the diseased rectum is removed. A new rectum (ileal pouch) is created using the small bowel. The new rectum is connected to the anal opening. A loop ileostomy is created to protect the area until it has healed.
When healing is complete, a third procedure is done to close the ileostomy. This three-stage UC procedure ultimately results in patients being able to live without an ileostomy.
In elective surgery, the first and second stages described above are combined. This is the two-stage surgery for UC, done through a minimally invasive or open procedure. Both the colon and rectum are removed. A new rectum or J-pouch is made from the small intestine and connected to the anal opening. A diverting ileostomy is often made to protect the area until it heals. After the patient recovers, a second procedure is performed to close the ileostomy and reconnect the small bowel. In select cases, some surgeons choose not to create a diverting ileostomy, which results in a one-stage procedure.
After surgery, five to six bowel movements a day and one at night can be expected. Infection may develop in the pouch. This is usually treated effectively with antibiotics. Due to complications, about 10% of pouches must be removed and an ileostomy created.
LONG TERM FOLLOW-UP
Regular follow-up medical appointments are scheduled. During these periodic visits, your physician will evaluate the function and health of the pouch.
WHAT IS A COLON AND RECTAL SURGEON?
Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum and anus. They have completed advanced surgical training in the treatment of these diseases as well as full general surgical training. Board certified colon and rectal surgeons complete residencies in general surgery and colon and rectal surgery, and pass intensive examinations conducted by the American Board of Surgery and the American Board of Colon and Rectal Surgery. They are well-versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions if indicated to do so.
The American Society of Colon and Rectal Surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention and management of disorders and diseases of the colon, rectum and anus. These brochures are inclusive but not prescriptive. Their purpose is to provide information on diseases and processes, rather than dictate a specific form of treatment. They are intended for the use of all practitioners, health care workers and patients who desire information about the management of the conditions addressed. It should be recognized that these brochures should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtain the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstancespresented by the individual patient.
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Ulcerative Colitis | ASCRS
FDA Approves Humira Biosimilar Cyltezo for Ulcerative Colitis, Crohn’s Disease, Other Illnesses – IBD News Today
Posted: at 8:49 am
The U.S. Food and Drug Administration(FDA) has approved Boehringer IngelheimsCyltezo a biosimilar of Abbvies Humira (adalimumab) to treat Crohns disease,ulcerative colitis and a host of other diseases ranging from rheumatoid arthritis toankylosing spondylitis.
Cyltezo is the German companys first FDA-approved biosimilar and marks an important step towards our goal of providing new and more affordable treatment options to healthcare providers and patients, Ivan Blanarik, senior vice-president and head of Boehringer Ingelheims therapeutic area biosimilars, said in a press release.
The FDAs Aug. 29 decision is thesecond biosimilar of Humira after the approval of AmgensAmjevitain September 2016. Another biosimilar of Humira, Imraldiby Samsung Bioepis, won approval by the European Medicines Agency (EMA) on Aug. 24.
The FDA granted its approval based on pharmacological, non-clinical and clinical data showing that Cyltezo is a biosimilar of Humira. The EMA is also expected to provide an opinion this year.
A biosimilar is a drug that is shown to be highly similar to another existing biological drug, according to the FDA. It should have no clinically meaningful differences in terms of safety and effectiveness from the reference product. It is usually manufactured by a concurrent company after the patent for the original product has expired.
As with Humira, warnings include risks of serious infections and malignancies, with reports of lymphomas in children and adolescent patients treated with anti-TNF therapy. Most reported adverse effects are infections, injection-site reactions, headaches and rash.
It is not known if Cyltezo is effective in people who stopped responding or could not tolerate previous anti-TNF therapy, as stated in the productsmedication guide.
Cyltezo is available as a pre-filled syringe at a dose of 40 mg per injection. Another delivery option, an auto-injector, is currently seeking approval.
Cyltezo is a TNF-alpha inhibitor. It acts by blocking the pro-inflammatory cytokine TNF-alpha, involved in many inflammatory diseases. It is also indicated in a range of diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis.
The FDAs full report isavailable here. No information has been released yet on the drugs commercial availability, but lawsuits are ongoing between Abbvie and Boehringer Ingelheim that may delay the products launch.
Posted: at 8:49 am
The primary goal in treating ulcerative colitis is to help patients regulate their immune system better. While there is no known cure for ulcerative colitis and flare ups may recur, a combination of treatment options can help you stay in control of your disease and lead a full and rewarding life.
Treatment for ulcerative colitis and other IBD varieties is multifaceted and includes the use of medication, alterations in diet and nutrition, and sometimes surgical procedures to repair or remove affected portions of your GI tract.
Medication for ulcerative colitis can suppress the inflammation of the colon and allow for tissues to heal. Symptoms including diarrhea, bleeding, and abdominal pain can also be reduced and controlled with effective medication.
In addition to controlling and suppressing symptoms (inducing remission), medication can also be used to decrease the frequency of symptom flare ups (maintaining remission). With proper treatment over time, periods of remission can be extended and periods of symptom flare ups can be reduced. Several types of medication are being used to treat ulcerative colitis today.
Search for you ulcerative colitis medication to learn more.
In some circumstances, a health care provider may recommend adding an additional therapy that will work in combination with the initial therapy to increase its effectiveness. For example, combination therapy could include the addition of a biologic to an immunomodulator. As with all therapy, there are risks and benefits of combination therapy. Combining therapies can increase the effectiveness of IBD treatment, but there may also be an increased risk of additional side effects and toxicity. Your health care provider will identify the treatment option that is most effective for your individual health care needs.
Read more about Ulcerative Colitis Medication.
While ulcerative colitis is not caused by the foods you eat, you may find that once you have the disease, particular foods can aggravate the symptoms. Its important to maintain a healthy and soothing diet that helps reduce your symptoms, replace lost nutrients, and promote healing.
For people diagnosed with ulcerative colitis, it is essential to maintain good nutrition because the disease often reduces your appetite while increases your bodys energy needs. Additionally, common symptoms like diarrhea can reduce your bodys ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.
Many people with ulcerative colitis find that soft, bland foods cause less discomfort than spicy or high-fiber foods. While your diet can remain flexible and should include a variety of foods from all food groups, your doctor will likely recommend restricting your intake of dairy foods if you are found to be lactose-intolerant. Watch this webcast to learn more about nutrition in inflammatory bowel diseases
In one-quarter to one-third of patients with ulcerative colitis, medical therapy is not completely successful or complications arise. Under these circumstances, surgery may be considered. This operation involves the removal of the colon (colectomy).
Depending on a number of factors, including the extent of the disease and the patient’s age and overall health, one of two surgical approaches may be recommended. The first involves the removal of the entire colon and rectum, with the creation of an ileostomy or external stoma (an opening on the abdomen through which wastes are emptied into a pouch, which is attached to the skin with adhesive).
Today, many people are able to take advantage of new surgical techniques, which have been developed to offer another option. This procedure also calls for removal of the colon, but it avoids an ileostomy. By creating an internal pouch from the small bowel and attaching it to the anal sphincter muscle, the surgeon can preserve bowel integrity and eliminate the need for the patient to wear an external ostomy appliance.
If you’re confused about all the medications and therapies out there, you are not alone! IBD is extremely complex, which is why we’ve teamed up with Emmi Solutions to break the information down into simpler terms through interactive animated videos.
Each video explains the pros, cons, and tradeoffs of various treatments. Armed with this information, you’ll be better equipped to discuss the options with your doctor and make the right decision. Watch the videos.
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Colitis Treatment | Treatments for Ulcerative Colitis …
European Commission Approves Biosimilar Imraldi for Crohn’s Disease and Ulcerative Colitis – IBD News Today
Posted: at 8:49 am
The European Commission has approved Imraldi, an adalimumab biosimilar referencing AbbVies Humiramaking the medication available to treat the same therapeutic indications as Humira, including Crohns disease, pediatric Crohns disease and ulcerative colitis.
The Aug. 24 decision followed a positive recommendation by the European Medicines Agencys Committee for Medicinal Products for Human Use, released in June.
Todays decision marks another positive step in transforming the lives of people with chronic autoimmune conditions, Jean-Paul Kress, Biogens executive vice-president and head of global therapeutic operations, said in a press release. As the number of approved biosimilars continues to grow, so does the anticipated potential to increase physician choice and patient access to biologics.
Imraldi was developed by Samsung Bioepis, a joint venture between Biogen and Samsung BioLogics. It is Biogens tgurd anti-TNF biosimilar medicine to receive European marketing approval following Benepali, an etanercept biosimilar referencing Enbrel,and Flixabi, an infliximab biosimilar referencing Remicade.
The approvalwas supported by strong preclinical and clinical data demonstrating Imraldis safety and efficacy profiles. Clinical data included results from a Phase 1 trial (NCT02144714) in healthy volunteers, and a Phase 3 study (NCT02167139) in rheumatoid arthritis patients that compared Imraldi with Humira.
That Phase 3 trial of544 patients with moderate-to-severe rheumatoid arthritis showed that 40 mg every other week via subcutaneous injection of each medicine over 24 weeks improved symptoms by 20 percent in about 72 percent of patients in each treatment group, despite methotrexate therapy.
Following this treatment period and up until week 52, some patients were switched from Humira to Imraldi. This change did not induced any immune reaction, further confirming the similarities between the two medicines.
Imraldi will be available for any patient older than 6 years of age with moderate-to-severe active Crohns disease who have not responded to corticosteroid or immunosuppressant treatment regimens, or who cannot toleratestandard-of-care therapies. Imraldi will also be approved to treatadult patients moderate-to-severe ulcerative colitis who do not respond to first-line of therapy with corticosteroids and Purinethol (6-mercaptopurine) or Azasan (azathioprine), who are intolerant, or who have medical contraindications for such treatments.
Ulcerative colitis breakthrough: THIS test for bowel disease could revolutionise diagnosis – Express.co.uk
Posted: August 24, 2017 at 12:40 pm
In ulcerative colitis, tiny ulcers develop on the surface of the lining of the large bowel.
Experts believe a fast, simple test for ulcerative colitis could provide a cheaper less invasive alternative for screening.
A colonoscopy is currently the main test for the condition.
Research by the Department of Physics and Astronomy and the Institute for Biomedical Sciences at Georgia State University found the testing procedure could more easily screen patients for ulcerative colitis.
A colonoscopy is a test which allows a doctors to look at the inner lining of the large intestine – which includes the rectum and colon, every five years or more frequently if abnormalities are found.
The test can help find ulcers, colon polyps, tumour and other areas of inflammation.
However, the procedure is uncomfortable and can also be expensive.
Experts said there was a need to be able to diagnose inflammatory bowel disease more effectively.
Dr A G Unil Perera, Regents’ Professor of Physics, said: Colonoscopy is used as a screening technique, so even if you dont know if a person has colitis or not, thats the only way to check and say they do.
We are not talking about replacing colonoscopy.
We have shown that a minimally invasive blood test can tell if patient has an indication of colitis. Then doctors can perform a colonscopy to see how far the disease has spread and whether there are signs of cancer.
Experts tested the blood test on mice with signs of colitis to test the accuracy of the procedure.
Ulcerative colitis only affects the colon – large intestine – but Crohn’s disease can affect any part of the digestive system, from the mouth to the anus.
Charity Crohns and Colitis UK said: Its estimated that UC affects about one in every 420 people in the UK – roughly 146,000 people.
The inflammation usually begins in the rectum and lower colon, but it may affect the entire colon.
If ulcerative colitis only affects the rectum, it is called proctitis, while if it affects the whole colon it may be called total colitis or pancolitis.
Seven things you didnt know about Crohns disease and ulcerative colitis