It was 1988 and I was just finishing my sophomore year when symptoms started. I knew this was more than just a stomach ache, not just because of the type of pain I was experiencing, but also because of the light bleeding that occurred every time I used the toilet. I will never forget that first episode. Even then, rectal bleeding set me off as “potential cancer” so I made an appointment with the college’s wellness center.
Without doing much research or suggesting that any tests should be done, the doctor concluded that it just had to be nerves and not to worry. Fast forward to the summer I didn’t have to worry about. My pain and symptoms only got worse and over the course of a few weeks I had lost 15 pounds. At 5’1 “and 105 pounds that really took a toll. I knew I had to see another doctor.
My doctor did some tests and officially diagnosed ulcerative colitis (UC). By then, I was also seriously anemic – so much so that I needed a blood transfusion. Since it was the height of the AIDS crisis, I was very suspicious, but at their insistence I moved on anyway. I stayed in the hospital for a week and I will never forget how weak and windy I was outside for just a few minutes. I definitely didn’t feel like a young 20 year old.
To begin treating my UC, doctors put me on a limited course of prednisone, the all-powerful corticosteroid drug that quickly suppresses inflammation but is also notorious for its mile-long list of uncomfortable side effects like insomnia, restlessness, mood swings. Weight gain and “moon face”.
My doctors also let me try a few other medications over the years, including some with fairly serious side effects, before finally being given mesalamine, another anti-inflammatory drug that was relatively new at the time. Fortunately, this seemed like the trick, and I’ve been on different versions of mesalamine for the past 30 years.
However, managing my UC involved much more than just taking medication. In addition to annual visits to my gastroenterologist and regular colonoscopies, I’ve learned about certain triggers that can often lead to a flare-up, such as: B. Too much coffee (a difficult question for me) or additional stress. Finding the right diet was also difficult as it is different for everyone and there is so much conflicting advice out there: fiber, fiber, dairy, no dairy, whole foods, raw foods, etc.
I’ve also had to try different medications over the years and make sure I use them diligently every day, even when I’m in remission.
One thing that helped me was participating in an online forum where I could find support and helpful advice by connecting with other people who also have UC or Crohn’s disease.
Early detection is the key to better results
I am just one of more than 3 million people in the US living with inflammatory bowel disease (IBD), the most common of which are UC and Crohn’s disease. UC and Crohn are characterized by chronic inflammation of the intestinal tract that causes abdominal pain, diarrhea, bloody stools, weight loss, fever, and fatigue. They affect approximately 750,000 Americans annually.
While Crohns can occur anywhere in the intestinal tract, it typically targets the small intestine, while UC only affects the large intestine (large intestine) and the innermost lining of the colon. Unfortunately, there is still no cure for UC or Crohns and there is no definitive cause, but in a recent interview, Dr. Ayanna Lewis, a gastroenterologist at Mount Sinai South Nassau Hospital in Oceanside, New York, pointed out some key findings.
“We are thinking about [IBD] This is an autoimmune process in which the immune cells in the intestine become overactive and trigger an inflammatory response. A variety of factors play a role in why this happens, including genetics, environment (mostly diet), and heredity (more common in Crohn’s than UC). “
Although the numbers of men and women with UC and Crohn are similar, Lewis stressed that women with both diseases should be extra careful when they are pregnant or trying to get pregnant. “Women need to have a medication talk with their GI doctor and coordinate with their gynecologist and pediatrician. If they have torches during pregnancy, they are more likely to have poor outcomes like miscarriages and low birth weight.”
People with IBD are more likely to have certain chronic conditions such as arthritis and cardiovascular, respiratory, kidney and liver diseases, but the increased risk of colon cancer is probably what worries people most. The risk increases sharply after 10 years of the disease, so detection early is key. It is recommended that people with UC or Crohn’s have a colonoscopy every one to two years.
Lewis adds, “This is exactly why we are so aggressive with it. In fact, when someone is treated and does regular colonoscopies, they are actually less at risk than the general public.”
In addition to regular checkups, you can lower your risk of colon cancer by following a healthy lifestyle that includes eating plenty of fruits, vegetables, and grains. Limitation of alcohol; get regular exercise; Watch your weight; and don’t smoke.
Ways to Treat Your Symptoms
Finding effective drugs to control symptoms is critical to treating UC and Crohn. Mesalamine, an anti-inflammatory drug sold under various brand names, has been a standard treatment for UC and Crohn for years.
“Mesalamines are aspirin-based compounds that treat the disease topically on the surface of the colon and reduce inflammation,” says Lewis. Recently, new therapies, including biologics, have been found to be even more effective in some cases, especially in more severe cases of UC and Crohn.
“We’ve really revolutionized things over the years,” says Lewis. “Now we have so many different treatments for the immune system. Biologics block the actions of the immune cells themselves before they can cause inflammation. They get to the source, which leads to better results.”
While biologics work well for some people, they are not for everyone. Other promising treatments such as immunomodulators, JAK inhibitors and S1P receptor modulators are on the horizon as possible alternatives.
How can people with UC and Crohn best cope with their disease? In addition to medication and regular screenings, Lewis emphasizes that eating a healthy diet is key.
“The quality of the food here [in the United States] is so poor. I think a lot of people might react to the food. “Lewis points to the high-sugar, high-fat, low-fiber Standard American Diet (SAD) in the US and other Western countries as a likely contributing factor to the increase in UC and Crohns.
“Try to eat whole foods as close to nature as possible. Don’t get an apple-flavored cereal, get an apple. I recommend the Mediterranean diet to my patients, which focuses on high-fiber, fish, lean and fresh meat products and vegetables Vegetables in their whole form. Working with a nutritionist is also helpful. ”
For those of us living with UC and Crohn, the main thing Lewis emphasizes is that you have good communication with your doctor and are honest about your symptoms and health.
“A lot of women tend to be downplayed by telling them, ‘It’s just stress; don’t worry.’ You have to be persistent, and we as doctors need to better address patient concerns. ”
Crohn’s and Colitis Foundation
Supported by educational grants from Bausch Health, Bristol-Myers Squibb, and Takeda Pharmaceuticals USA, Inc.