Drug Therapy in Ulcerative Colitis

Abstract

The two primary types of inflammatory bowel disease (IBD) are ulcerative colitis (CU) and Crohn's disease (CD). These two diseases have many similarities and sometimes are difficult to distinguish from each other. However, there are several differences. UC is an inflammatory destructive disease of the large intestine characterized by motility and secretion disorders. Inflammation usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. UC rarely affects the small intestine except for the end section, called the terminal ileum. UC may also be called colitis or proctitis. Inflammation makes the colon empty frequently, causing diarrhea. Ulcers formed in places where the inflammation has killed the cells of colon, bleeding ulcers and pus discharge. UC is an IBD that causes inflammation in the small intestine and colon. UC can be difficult to diagnose because its symptoms are similar to other intestinal disorders and another type of IBD called CD. CD differs from UC because it causes deeper inflammation within the intestinal wall. Also, CD usually occurs in the small intestine, although it can also occur in the mouth, esophagus, stomach, duodenum, large intestine, appendix, and anus. UC may occur in people of any age, but most often it starts between ages of 15 and 30, or less frequently between ages of 50 and 70. Children and adolescents sometimes develop the disease. UC affects men and women equally and appears to run in some families. Clinical and epidemiological data do not support a simple Mendelian model of inheritance for IBD. In its place CD and UC are considered to be complex polygenic diseases. UC is a chronic disease in which the large intestine becomes inflamed and ulcerated (pitted or eroded), leading to flare-ups (bouts or attacks) of bloody diarrhea, abdominal cramps, and fever. The long-term risk of colon cancer is increased [1-4]. The etiology is unknown for ulcerative colitis (UC). The consensus is so far that it is a response to environmental triggers (infection, drugs, or other agents) in genetically susceptible individuals. The genetic component is not as strong in UC as it is in CD. However, 10%-20% of patients with UC have at least one family member with IBD [1,2]. There are marked differences between ethnic groups with some (such as Ashkenazi Jews) having a particularly high incidence. Non-steroidal anti-inflammatory drugs may cause an episode of acute active disease in some patients with IBD. UC primarily affects young adults, but it can occur at any age from five to eighty years and women tend to be more commonly affected than men. It is a worldwide disorder with high-incidence areas that include United Kingdom, the United States, northern Europe and Australia. Low-incidence