Talk:Management of ulcerative colitis

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Poop transplant

This article should cite that severe case of colitis can be cured with 'poop' transplant, as explained here http://www.the-scientist.com/news/display/57795/ —Preceding unsigned comment added by Dalloliogm (talk • contribs) 12:01, 4 November 2010 (UTC)[reply]

Except where it isn't cured, hence, doesn't count, for some people. It's a complex problem, hence the solution is not so simplistic. If anything, it would be a third potential treatment, after two far more effective treatments are attempted and met with minimal success or even failure. Of course, you offered zero citations, so I'll return that level of respect.Wzrd1 (talk) 03:58, 25 January 2012 (UTC)[reply]

{{fixme}}

I like the reference to vitamin U, but I'm not sure that identifying it as a chloride (alkaloid?) is very helpful. The simple juice extract of cabbage is helpful, but the whole leaf is probably better and cheaper. BrewJay (talk) 11:20, 27 May 2008 (UTC)[reply]

Content out of scope

I moved the following section to here, because I think it is out of the scope of this article, and is already dealt with in Ulcerative_colitis#Clinical_presentation. Mikael Häggström (talk) 10:16, 29 October 2010 (UTC)[reply]

Clinical presentation

GI symptoms

The clinical presentation[1] of ulcerative colitis depends on the extent of the disease process. Patients usually present with diarrhea mixed with blood and mucus, of gradual onset. They also may have signs of weight loss, abdominal pain and blood on rectal examination.

Ulcerative colitis is a systemic disease that affects many parts of the body. Sometimes the extra-intestinal manifestations of the disease are the initial signs, such as painful, arthritic knees in a teenager. It is, however, unlikely that the disease will be correctly diagnosed until the onset of the intestinal manifestations.

Extent of involvement

Ulcerative colitis is normally continuous from the rectum up the colon. The disease is classified by the extent of involvement, depending on how far up the colon the disease extends:

  • Proctitis: Involvement limited to the rectum.
  • Proctosigmoiditis or distal colitis: Involvement of the rectosigmoid colon, the portion of the colon adjacent to the rectum.
  • Left-sided colitis: Involvement of the descending colon, which runs along the patient's left side, up to the splenic flexure and the beginning of the transverse colon.
  • Pancolitis: Involvement of the entire colon, extending from the rectum to the cecum, beyond which the small intestine begins.

Severity of disease

UC patients may be characterized by the severity of their disease:

  • Mild disease correlates with intermittent loose bloody stools (up to 4 times a day) with passage of thick, white mucus. Involvement is usually limited to the rectum (proctitis) or the rectosigmoid colon (proctosigmoiditis or distal colitis). There may be mild abdominal pain or cramping. Patients may believe they are constipated when in fact they are experiencing tenesmus, which is a constant feeling of the need to empty the bowel accompanied by involuntary straining efforts, pain, and cramping with little or no fecal output. Rectal pain is uncommon.
  • Moderate disease correlates with frequent loose bloody stools (about 10 times a day), anemia (not requiring transfusions), moderate abdominal pain, and low grade fever, 38 to 39 °C (100 to 102 °F). Involvement can extend up to the splenic flexure (left-sided colitis).
  • Severe disease, or fulminant disease, correlates with more than 10 loose bloody stools a day, severe abdominal cramps, fever up to 39.5 C, anemia requiring transfusions, hypotension, and rapid weight loss with inadequate nutrition. Involvement may or may not extend to the cecum (pancolitis). Patients in this category may have inflammation extending beyond just the mucosal layer, causing impaired colonic motility and leading to toxic megacolon. If the serous membrane is involved, colonic perforation may ensue.

Content within scope

The following section was found in Ulcerative colitis, and I think it would rather fit into this article, but I'm not sure yet exactly where. Help is appreciated to integrate it. Mikael Häggström (talk) 10:23, 29 October 2010 (UTC)[reply]

It is best practice to discuss edits/removals from articles before actually committing them - especially if you are uncertain.
"Ongoing research" is still a valid heading - ref [1]
LDN is largely a patient-funded research and as such the significant investments needed for clinical trials are progressing at a slow pace indeed.
Greylensman (talk) 21:54, 12 November 2010 (UTC)[reply]
I agree it is generally best to discuss edits/removals before committing them, but in this case I was certain enough that the article would be better off without this information. Regarding the heading, I agree that it is a very important concept, and I have all respect for the trials and studies in progress at LDNscience. However, it is a less appropriate naming of a header within Wikipedia, because such sections tend to eventually become filled with random trivia that has ever been mentioned in studies about the disease. Therefore, I moved the pathophysiology part of that section into the specific pathophysiology section. I considered the remaining text, mainly relating to treatment, to better fit in this article. The main reason, however, that it ended up here, was actually not because I couldn't find a proper place for it, but rather because it needs further verification before any inclusion, and I'm sorry for not earlier pointing that out. The infliximab claim is completely unreferenced, and the low-dose naltrexone and phosphatidylcholine have no apparent verification of any actual efficacy in ulcerative colitis. I think it is better to wait until those studies have yielded any actual results before coming to any conclusion. Again, I'm sorry for not pointing this out right away. Mikael Häggström (talk) 05:49, 13 November 2010 (UTC)[reply]
LDN is under research, that is a fact as well as relevant information. It is hardly "random" information.
Remicade(European name) or Inflixmab(US name) is well established for treating both Morbus Crohn's and Ulcerative Colitis at Rikshospitalet University Hospital in Norway. They refer to good results in clinical trials on their public information pages, so there should exist references to it. Unfortunately Remicade can also develop quite serious side-effects for some patients - in which case the treatment must be discontinued. This together with cost is why it is generally reserved for the most serious cases where the patient has not responded to the more established treatments. Greylensman (talk) 18:26, 29 November 2010 (UTC)[reply]

Ongoing research

Recent evidence from the ACT-1 trial suggests that infliximab may have a greater role in inducing and maintaining disease remission.

Low dose naltrexone and alkaline phosphatase[2] are under study for treatment of Crohn's disease and ulcerative colitis.

  1. ^ Hanauer SB; Hanauer, Stephen B. (1996). "Inflammatory bowel disease". N. Engl. J. Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552. {{cite journal}}: Unknown parameter |month= ignored (help)
  2. ^ Tuin A, Poelstra K, de Jager-Krikken A, Bok L, Raaben W, Velders M P, Dijkstra G (2009). "Role of alkaline phosphatase in colitis in man and rats". Gut. 58: 379–387. doi:10.1136/gut.2007.128868.{{cite journal}}: CS1 maint: multiple names: authors list (link)

"Drugs"

The section on herbal treatment used the term "drugs" in a pejorative manner, suggesting that an herb is a natural alternative to a drug. Rather, both are drugs meant to treat a condition, with the difference being that one is synthetic (manufactured) and the other is of natural origin. I added the term manufactured to drop the pejorative sense. — Preceding unsigned comment added by 180.222.156.131 (talk) 10:38, 18 October 2011 (UTC)[reply]

I respectfully disagree. Morphine is derived from a natural source, indeed, it can be dosed (somewhat chaotically) from the poppy sap to a patient, hence it is NOT synthetic, yet BOTH are still drugs. Indeed, laudanum WAS a drug in common use until morphine and codeine were separated from the plant residue. Laudanum was produced by simply placing the dried sap of the poppy into alcohol, I guess that is synthetic in some views. Manufactured, purified drug from natural source or come up with some other alternative, but otherwise, drug vs herbal treatments IS a valid separation. And I HAVE been known to use herbal medicine for some emergent uses, when a drug wasn't available, but certain herbs and other plant matter were available. Sorry, but SCIENCE can't cut only one way.Wzrd1 (talk) 04:06, 25 January 2012 (UTC)[reply]

Probiotics

The probiotics section lacks citations completely. As such, it shouldn't actually be part of this article at all, and opens the door to random additions. Prayer, spaghetti monster, etc. I left it in, worrying this is a gray area as it is plausible (though plausibility is *not* sufficient for including in an encyclopedia article) and flagged it as "citation needed". I deleted the following sentence: One study looked at a probiotic known as VSL-3 has shown promise for people with ulcerative colitis. There is no article for VSL-3, the study is not even named, let alone referenced. So this is a mystery substance with a mystery study, and as such I think fails the smell test for inclusion here. If someone can find the study, check the reference for suitability, I think the reference would be OK, better yet if they can make an article on VSL-3 before citing it as treatment for ulcerative colitis. People will be reading this article looking for treatment advice so I think facts are particularly important. — Preceding unsigned comment added by 180.222.156.131 (talk) 10:45, 18 October 2011 (UTC)[reply]

I'd conditionally agree, save that the established science doesn't back removal, only clarification and CITATIONS, PEOPLE! THERE, I agree, though I lack sufficient time to provide them. I've READ publicly available documents from NIH and other sources, it shouldn't take much effort for authors with a few minutes of time to include them! Though, those articles mentioned only mild effectiveness of said treatment.Wzrd1 (talk) 04:09, 25 January 2012 (UTC)[reply]

citations

Almost nothing is cited in this article. I picked up on it once it got down to making statements in the alternative section. The science section describes the condition, lists the treatment protocol, and so forth, without citing anything at all. It sounds accurate but is it accurate? What's this based on? I flagged the entire thing as needing citations as a result. Not a big wikipedia editor, but a colitis sufferer and I would like to know what is authoritative and what is speculation from people trying to sell crap. — Preceding unsigned comment added by 180.222.156.131 (talk) 10:52, 18 October 2011 (UTC)[reply]

The article remains the same, a lot of uncited information, hence, OR information, hence worthy of deletion. Kindly honor Wilipedia's values and CITE sources with statements or risk having OR deleted.Wzrd1 (talk) 04:10, 25 January 2012 (UTC)[reply]

Cannabis

These publications are mostly about Crohn's, but might be promising for UC:
http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2011&month=08&page=455
http://dx.doi.org/10.1016/j.cgh.2013.04.034
The latter is very promising, but this article is not included in my university's subscription and thus costs 30 USD.
--ebi. (talk) 22:55, 15 June 2013 (UTC)[reply]

Organisation of page

I was wondering if "treatment of complications" should be another section, which would include all the "treatments off" (proctitis, pancolitis etc). Rather than just under medication. Any thoughts on this? Pishoygouda (talk) 04:39, 5 September 2014 (UTC)[reply]

So no one has been on here for a while... so i just took the liberty of seeing how it looks! Let me know what you think! Pishoygouda (talk) 00:45, 6 September 2014 (UTC)[reply]

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