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Inflammatory Bowel Disease Treatment

Inflammatory bowel disease is a broad term that refers to any condition causing inflammation of the digestive tract. This can include the stomach, small intestine, large intestine (colon) and rectum. Crohn’s Disease and Ulcerative Colitis are chronic autoimmune diseases that cause the gut to become red, hot, swollen, tender and incapable of performing its normal function. This can lead to a range of symptoms, such as diarrhoea, pain, bleeding, severe fatigue, weight loss, anaemia and bowel obstruction. These symptoms can be extremely distressing and, if poorly controlled, can result in hospitalization and the need for surgery to remove the affected parts of the digestive tract.

Australia has one of the highest rates of inflammatory bowel disease in the world. In 2018, approximately 75,000 Australians suffered from ulcerative colitis and approximately 92,500 from Crohn’s disease. By 2022, these numbers are expected to rise to over 80,000 Australians with ulcerative colitis and nearly 100,000 with Crohn’s disease.

The exact cause of inflammatory bowel disease is unknown. Current research shows that there is a strong genetic link, but environmental and lifestyle factors are also thought to play a role. Infection with bacteria or viruses, the use of tobacco and the type of bacteria present in the ‘normal flora’ of the gut can all have an effect on the development of inflammatory bowel disease.

Crohn’s Disease Treatment

Crohn’s disease is a form of inflammatory bowel disease that can affect any part of the digestive tract, from the stomach to the anus. It causes inflammation of the full thickness of the gut wall. Treatment aims to control symptoms by reducing this inflammation, primarily through the use of medications, although lifestyle changes such as staying hydrated, exercising and limiting certain foods (such as spicy meals and caffeine) can also be useful.

Medications commonly used for Crohn’s disease include:

  • Analgesics (e.g. paracetamol), to control mild pain;
  • Loperamide (Imodium®, Gastro-Stop®), to slow or stop diarrhoea;
  • Aminosalicylates (e.g. sulfasalazine, mesalazine), to help control inflammation in mild to moderate disease;
  • Corticosteroids (e.g. prednisolone), to decrease inflammation and reduce the overactivity of the immune system in moderate to severe disease; and
  • Immunosuppressants (e.g. mercaptopurine, azathioprine, methotrexate), to reduce the overactivity of the immune system that is responsible for Crohn’s disease. These medications can take several weeks to start working.

Biological therapies (sometimes referred to as ‘immunotherapy’) are a newer class of medication that has been used with great success for Crohn’s disease treatment. These treatments work by targeting the parts of the immune system that are responsible for triggering inflammation. Examples of biologic therapies include:

  • Remicade® (infliximab);
  • Entyvio® (vedolizumab);
  • Stelara® (ustekinumab); and
  • Humira® (adalimumab).

Many of these biological therapies must be given directly into the bloodstream by intravenous infusion, administered by a nurse specifically trained in their use. Many people regularly attend a major hospital or associated outpatient centres to have such doses administered and appointments can take up a large part of the day.

In many cases, it is possible for these infusions to be administered in your own home by one of our highly trained nurses. Contact one of our friendly team members to see if home infusions with View Health – chemo@home might be suitable for you.

Ulcerative Colitis Treatment

Ulcerative colitis is a form of inflammatory bowel disease that only affects the large bowel (colon and/or rectum). It causes inflammation of the surface layers of the lining of the bowel only. Symptoms usually occur as intermittent attacks between periods of no symptoms (‘remission’), although 5 to 10% of people can experience symptoms all the time. The treatment options for ulcerative colitis depend on the severity of the symptoms.

Medications are commonly used to provide symptomatic control, reduce inflammation and prevent ongoing damage to the gut. Symptoms may be controlled by taking medications that help relieve pain, diarrhoea, abdominal cramping and supplement your diet (e.g. iron, calcium and vitamin D supplements).

Other medications used to treat ulcerative colitis may include:

  • Aminosalicylates (e.g. sulfasalazine, balsalazide, olsalazine, mesalazine), to help control inflammation in mild to moderate disease;
  • Corticosteroids (e.g. prednisolone, budesonide), to decrease inflammation and reduce the overactivity of the immune system in moderate to severe disease; and
  • Immunosuppressants (e.g. mercaptopurine, azathioprine, methotrexate), to reduce the overactivity of the immune system that is responsible for ulcerative colitis. These medications can take several weeks to start working.

If these medications don’t provide sufficient control of the disease, biologic agents (sometimes referred to as ‘immunotherapy’) may be an option. This class of medication target the parts of the immune system responsible for triggering inflammation. The most common biologic therapies used for ulcerative colitis treatment are:

  • Remicade® (infliximab);
  • Entyvio® (vedolizumab); and
  • Humira® (adalimumab).

Many of these biological therapies must be given directly into the bloodstream by intravenous infusion, administered by a nurse specifically trained in their use. Many people regularly attend a major hospital or associated outpatient centres to have such doses administered and appointments can take up a large part of the day.

In many cases, it is possible for these infusions to be administered in your own home by one of our highly trained nurses. Contact one of our friendly team members to see if home infusions with View Health – chemo@home might be suitable for you or your patients.

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