Biological treatments, administered through an IV or a shot, have anti-TNF agents, which inhibit the body's inflammatory response but have potential side effects such as lymphoma, infections, congestive heart failure, demyelinating disease, a lupus-like syndrome, induction of auto-antibodies and injection site reactions.
Immunosuppressive drugs have the same goal of preventing the immune system's activity and also have nasty side effects because the immune system is less able to resist infections and the spread of malignant cells. Both biological treatments and immunosuppressive drugs are calculated according to body weight, so the more I weigh, the more medications I can take! That's why I eat so much cake.
Corticosteroids reduce inflammation and are generally taken for a short period of time because they have harmful long term side effects, including osteoporosis and diabetes. In the short term, side effects can be a moon face, weight gain, acne, mood swings, insomnia, increased energy and concentration. Luckily besides making UC sufferers feel great for a couple months, corticosteroids also make triple-tasking really easy. For example, my family always jokes that my dad got his MBA degree in night classes because he was taking a corticosteroid.
Last of all, aminosalicyates are used to treat mild to moderate UC and are, surprise, anti-inflammatory drugs. At the moment, I am taking a biological treatment called Remicade. Every 6 weeks I go to the hospital to receive a 3-hour infusion that is essentially like a very low dose of chemotherapy. I am also taking an immunosuppressive drug called Azathioprine, which comes in pill form and is taken every day. I have taken all four classes of drugs, and I will relate the saga of my drug journey (if I can even remember what happened. No just kidding) in a future post.
The tricky aspect of medications is the balance of side effects and positive effects. From the list above, it is clear that the side effects can have harmful long term effects that can outweigh the positive short term effects. Sometimes I feel sick just because of medication and not even because I have ulcers in my colon! That's just silly. In the end, the cost of drug treatment on a UC sufferer's health has to be compared with the last-ditch option for UC, which is a colectomy, or surgery to remove to the colon. But don't get ahead of yourself. I'll talk about that later.
One of the words that you might have noticed in the never-ending drug list was "steroid." If you haven't seen me in person, you might even think I was an athlete. I am sorry to disappoint you, but I'm not an athlete and I haven't exercised since I got sick because it makes me feel even worse. Steroids are a major element in any drug treatment for colitis because they can rapidly improve a patient's health and even induce remission. As UC is a chronic disease, it is all about remission and relapses. For many people, a corticosteroid called prednisone can bring them back into remission. Prednisone is also used for rheumatoid arthritis, organ transplants, asthma and other things you don't want to have. Sometimes people call it a miracle drug, but the truth is that any drug that makes someone who is very sick feel better seems like a miracle drug to them.
The details about drug treatment can seem overwhelming. No drug is without its drawbacks. Most people respond to one drug combination or another. The encouraging aspect about drug treatment and medical research in general is that progress is being made all the time. In fact, one of the biological drugs I tried had only been on the market for six years. In another six years, who knows what may be available. Judging from what I just outlined, you might not imagine that patients can run out of drugs to try. Nonetheless, it happens to many UC sufferers, and for various other reasons, 25-40% end up getting surgery. But that's for next time!
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