For those most severely suffering from ulcerative colitis, biological therapy can lead to a normal life. Currently, doctors almost exclusively remove the large intestine, and this should be a last resort, say the representatives of the J-elite Society.
Ulcerative colitis (UC), in Latin, Colitis ulcerosa (CU) is a chronic inflammation of the large intestine. The immune system attacks its own tissues. Genetic factors also play a role. The disease runs in families. Gradually, the number of bowel movements increases, diarrhea increases, and blood appears in the stools. Often, doctors mistakenly recognize it as hemorrhoids.
There can be as many as 20 bowel movements a day. Other symptoms include: sudden, painful urge to stool, weakness, fever, loss of appetite, and sometimes weight loss. A serious complication – acute distension of the colon (megacolon toxicum) – is at risk of perforation of the intestine, the most serious being colorectal cancer.
The disease usually occurs between the ages of 15 and 35. Exacerbations are separated by periods of remission. The number of sick Poles can be as high as 40, every fifth has the most severe form of the disease.
Currently, doctors are unable to cure UC, but they control symptoms better and better. However, anti-inflammatory and immunosuppressive medications do not always work. Until recently, when pharmacotherapy did not bring the desired effects, the only solution was colectomy, the complete removal of the large intestine. It is an operation with the possibility of numerous complications. For example, it almost triples the risk of infertility in women.
Removal of the large intestine together with the rectum requires the creation of a stoma – an artificial outlet of the small or large intestine to the surface of the abdominal skin, through which the feces are drained into the bags. It is only after some time that the normal route of excretion can be restored – unless complications arise.
In recent years, an alternative to crippling surgery has emerged. Biological drugs strongly affect the immune system. They reduce the inflammatory process, accelerate remission and extend its duration.
Biological drugs are a group of drugs closely related to biologically active molecules naturally occurring in the human body. These can be naturally occurring molecules (insulin, erythropoietin, growth factors). They are also substances designed to influence various mechanisms underlying disease (interleukin antagonists).
Polish experience shows that biological drugs bring the desired effects and surgery is avoided. This treatment should be available for selected cases – believes prof. Grażyna Rydzewska, national gastroenterology consultant at CSK MSWiA in Warsaw.
Patients with UC – mainly young people – associated in the J-elita Society for the Support of People with IBD, together with prof. Rydzewska and doctors from centers in various cities, appeal for the possibility of reaching for biological drugs in patients who are not helped by standard therapy.
According to the representatives of the J-elite, surgery should be a last resort, not the only solution.
So far, no therapeutic program for CU has been developed.
Operations are not always successful. Patients must undergo further treatments. Often, the stoma remains for life. When counting the costs of biological therapy, one should also count the expenses for hospitalization, surgery, rehabilitation and the costs of pensions and reimbursed ostomy equipment. Our most important goal is to improve the availability of biological therapy for patients with severe form of UC, says Prof. Rydzewska. (PAP)
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