Author: Gaurav Verma

Ulcerative Colitis Treatment

 

Ulcerative colitis

ulcerative colitis
ulcerative colitis

Ulcerative colitis (UC) is a chronic disease that causes inflammation and ulcers (open sores) in the innermost layers of the large intestine. UC is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation in the intestines. In UC, swelling typically occurs in the rectum and lower colon, but the inflammation can spread throughout the entire colon. The ulcers bleed and produce pus and mucus, and the inflammation causes the colon to empty frequently, resulting in diarrhea.

ulcerative colitis colon

UC is a rare, but serious disease that affects 50 out of every 100,000 people in the United States. Although the condition most commonly affects those between the ages of 15 and 35, children and older adults may also develop the disease. UC occurs five times more frequently in those with a Jewish heritage than it does in the general population. Although most people with UC can be successfully treated without surgery, roughly 25% will need a colectomy (surgical removal of the colon).

 

Signs and Symptoms

The most common signs and symptoms of UC include abdominal pain and bloody diarrhea. The symptoms can range from mild to severe and may come on either very suddenly or more gradually.

Other common symptoms of UC include:

  • Frequent, even continuous diarrhea
  • Bloody stool
  • Urgent desire to defecate
  • Abdominal cramps and pain
  • High fever
  • Rapid heartbeat
  • Weight loss
  • Anemia
  • Loss of appetite
  • Joint aches

People with UC are at increased risk for malnutrition. UC can also cause a host of other problems, including arthritis, eye infections, liver disease, skin rashes, blood clots, or gallstones. Although it is not clear why such problems occur outside the colon, some researchers speculate that they may be linked to a faulty immune response.

 

Causes

factors of ulcerative colitis
factors of ulcerative colitis

There are many theories regarding the cause of UC, but none have been proven. The most likely theory is that UC is caused by a variety of factors ranging from genetics, faulty immune system reactions, stress, environmental influences, and even diet. For example, some people are genetically at risk for UC (it runs in their family), and an infection or other toxin may stimulate inflammation of the large intestine. In some cases, stressful events or sensitivities to certain foods may trigger symptoms of UC.

 

Risk Factors

  • Family history of UC
  • Jewish heritage, especially Ashkenazi Jews
  • A diet high in sugar, cholesterol, and fat (particularly from meat and dairy products)
  • Stress

 

Diagnosis

 

ulcerative colitis diagnosis
ulcerative colitis diagnosis

A healthcare practitioner will perform a thorough physical exam as well as a series of tests to diagnose UC. Blood tests may reveal a high white blood cell count (a sign of inflammation somewhere in the body). Stool samples may indicate whether there is bleeding or infection in the colon or rectum.

A procedure called colonoscopy—in which an endoscope (a long, flexible, lighted tube connected to a computer and television monitor) is inserted into the anus to enable investigation of the inside of the colon and rectum—may be performed. A colonoscopy can reveal any inflammation, bleeding, or ulcers on the colon wall. Tissue samples (biopsies) may be taken from the colon wall for examination under a microscope in order to make a definitive diagnosis of UC.

 

Preventive Care

A daily dose of sulfasalazine, one of the most common medications used to treat UC, is an effective means of reducing the number of UC relapses. Diet (especially a low-fat diet rich in fruits, fluids, magnesium, and vitamin C), exercise, and stress reduction techniques (including hypnosis) may also help prevent recurrences. Supplements and herbs are used successfully to treat UC, but whether or not they can prevent recurrences or stave off the disease in those who are genetically at risk is unknown.

 

Treatment Approach

The primary goal in treating UC is to control inflammation and replenish lost nutrients. The choice of treatment for UC depends on the severity of the disease. For example, people with mild to moderate UC are usually treated with medications that reduce swelling and suppress the immune response. More severe cases of UC may require surgery. In addition to medications, many people with inflammatory bowel diseases such as UC commonly turn to complementary and alternative remedies. Although these remedies still require extensive research, preliminary studies indicate that lifestyle changes, including stress reduction, dietary adjustments (such as including a rich variety of fruits and vegetables and maintaining low levels of fat and sugar), specific herbs and supplements (such as psyllium and Salai guggal) and mind/body techniques (such as hypnosis) can help prevent and/or treat the disease.

 

Lifestyle

yoga
Women practicing yoga in a class

At least one study has shown that IBD often begins within 1 year of a very stressful life event, such as the death of a family member. In addition, people with UC report that stress worsens their symptoms. Therefore, relaxation techniques, such as yoga, tai chi, and meditation are worth considering, particularly for people with chronic stress in their lives.

Exercise may also be very helpful for those with UC. Although exercise is generally considered safe for people with UC, those with the condition must take certain precautions when exercising and should talk to their healthcare practitioners before starting an exercise program. It is especially important for people with UC to drink one to two glasses of water before exercising and one glass of water every twenty minutes while exercising to prevent dehydration. Exercise should be avoided during symptom flare-ups or if the individual has a fever.

 

Medications

The following medications can help reduce the symptoms of UC and decrease the likelihood of recurrences:

  • Sulfasalazine—the most commonly used medication for UC; taken orally; decreases inflammation, reduces frequency of recurrences
  • Mesalamine—decreases inflammation; taken orally or as an enema
  • Corticosteroids—reduce inflammation by decreasing the production of prostaglandins (fatty acids that produce pain and inflammation); taken orally, given intravenously in severe cases, or may be prescribed as an enema
  • Medications that suppress the immune system (such as azathioprine and cyclosporine)

Antibiotics

Medications used to treat diarrhea (such as diphenoxylate, loperamide, or opiates) must be used only under medical supervision and with extreme caution. These medications slow down the normal movements of the gastrointestinal tract and, in severe cases of UC, may cause a complication known as toxic megacolon.

 

Surgery and Other Procedures

 

surgery
Surgeons at work

Approximately 20% to 30% of people with UC must eventually have their colons removed (colectomy) because of massive bleeding, severe illness, rupture of the colon, or the risk of cancer. There are several different types of surgery available for UC, and choosing the appropriate surgery depends on the severity of the disease and the individual’s needs, expectations, and lifestyle.

Many people with UC must have a proctocolectomy—a procedure in which the colon, anus, and rectum are surgically removed. The surgery cures UC, and removes any risk of colon or rectal cancer. When the intestines are removed, however, the body needs a new way for waste to leave the body so the surgeon creates a small opening (stoma) in the abdomen for stool to pass through. A pouch is worn over the opening to collect waste, and the individual empties the pouch as needed. Different types of procedures may be performed depending on which parts of the intestines are involved:

Ileostomy—colon and rectum are removed and the surgeon attaches the bottom of the small intestine to the stoma; waste travels through the small intestine and exits the body through the stoma

Colostomy—rectum is removed and the surgeon attaches the colon to the stoma (a temporary colostomy may be performed when part of the colon is removed and the rest needs to heal)

Ileorectal and ileoanal reservoir surgery—diseased part of colon and/or rectum is removed and the surgeon creates an internal pouch from the small intestine; waste is stored in the pouch and passed through the anus in the usual manner; bowel movements occur more frequently (on average, 5 to 7 times per day); risks include leakage of stool at night and infection of the pouch

 

Nutrition and Dietary Supplements

Diet

food to avoid in ulcerative colitis
food to avoid in ulcerative colitis

Preliminary evidence suggests that certain dietary patterns may be associated with UC. For example, some studies indicate that low fruit and vegetable consumption and high fat and sugar consumption may increase an individual’s risk for developing UC. Studies also suggest the following:

A bland, low-fiber diet is best during acute flare-ups.

Regular intakes of fruits and vegetables, and lowered fat and sugar consumption when UC is not active may reduce the likelihood of flare-ups.

High intakes of fluids and foods rich in magnesium and vitamin C on a regular basis may lower the risk of developing inflammatory bowel diseases.

Certain foods may aggravate symptoms of UC (including chocolate, dairy products, fats, and artificial sweeteners) and should be avoided by people with the condition.

After surgery, people with UC should avoid foods high in organic acids known as oxalates (for example, spinach, rhubarb, beets, coffee, tea, diet sodas, and chocolate) because oxalates can increase the risk of kidney stones.

People with significant malnourishment, severe symptoms, or those awaiting surgery may require total parenteral nutrition (nutrition maintained entirely by intravenous injection).

Vitamins and Minerals

Because many people with UC have vitamin and mineral deficiencies (due to decreased nutritional intake and absorption by the colon and excessive diarrhea), a multivitamin is recommended. Further research is needed to determine whether specific vitamin or mineral supplements may help treat the symptoms of UC.

Omega-3 Fatty Acids

omega 3 fatty acids
omega 3 fatty acids

At least one study has found that, compared to placebo, fish oil supplements containing omega-3 fatty acids may reduce symptoms of UC and prevent recurrence of the condition. The supplements are less effective than sulfasalazine, however, at reducing inflammation in people with mild to moderate UC. Some experts suggest that omega-3 fatty acids may prove particularly valuable when used in combination with sulfasalazine or other medications.

Vitamin B9 (Folate)

People with UC often have low levels of folate in their blood cells and some experts suggest that this may be due, at least in part, to sulfasalazine use. Some researchers speculate that folate deficiencies contribute to the risk of colon cancer in those with UC. Although preliminary studies suggest that folate supplements may help reduce tumor growths in people with UC, further research is needed to determine the precise role of folate supplementation in people with inflammatory bowel diseases.

N-acetyl glucosamine

Preliminary evidence suggests that N-acetyl glucosamine supplements or enemas may improve symptoms of UC in children with IBD who did not improve after using other treatments, but further research is needed to determine whether the substance is safe and effective for the treatment of UC.

Probiotics

Animal studies and preliminary human studies have found that probiotics, or “good” bacteria such as lactobacillus, may improve symptoms of UC and help prevent flare-ups. Further research is warranted.

 

Herbs

 

Psyllium seeds (Plantaginis ovatae)

A study comparing the use of psyllium seeds to the prescription drug mesalamine in people with UC reveal that the fiber-based supplement may be as effective as the medication in decreasing recurrences of the disease. More research is needed to confirm the conclusion of the authors of this study.

A professional herbalist may also recommend the following herbs to reduce inflammation and diminish abdominal cramps associated with UC:

  • Marshmallow root (Althaea officinalis)
  • Siberian ginseng (Eleutherococcus senticosus)
  • Turmeric (Curcuma longa)
  • Ginger (Zingiber officinale)
  • Green tea (Camillia sinensis)
  • Bromelain (Ananas comosus)
  • Wild yam (Dioscorea villosa)
  • German chamomile flower (Matricaria recutita)
  • Yarrow (Achillea millefolium)

 

Mind/Body Medicine

 

Hypnosis

Studies have shown that hypnosis improves immune function, increases relaxation, decreases stress, and ease feelings of anxiety. Many healthcare practitioners and people with UC have reported that symptoms of the disease improve with relaxation methods such as hypnosis, meditation, and biofeedback.

 

Ayurveda

Salai guggal (Boswellia serrata)

boswellia serrata
boswellia serrata

Salai guggal is a traditional Ayurvedic therapy used to treat symptoms of IBD. Findings from one study suggest that this remedy may be as effective as sulfasalazine for the treatment of UC. Side effects of salai guggal use include nausea, abdominal fullness, stomach pain, and anorexia.

 

Other Considerations 

Pregnancy

 

pregnancy and ulcerative colitis
pregnancy and ulcerative colitis

Fifty percent of women in remission experience a recurrence of UC when they become pregnant, usually during the first trimester or during the postpartum period. For this reason, such women should continue maintenance therapy under the guidance of their healthcare practitioner. Corticosteroids or sulfasalazine are considered safe during this time because these drugs do not harm the fetus. Pregnant women with UC do not have increased risk for stillbirths or premature deliveries.

Pregnant women should avoid high doses of vitamins. An obstetrician can provide instructions regarding appropriate multivitamin use during pregnancy.

 

Warnings and Precautions

People with UC should avoid herbs that loosen the bowels. These include:

Buckthorn bark (Rhamnus frangula)

Cascara sagrada bark (Rhamnus purshiana)

Senna leaf and senna pod (Senna alexandrina)

The following foods should also be avoided by people with UC because they worsen symptoms of the disease:

  • Milk (and milk products)
  • Spicy foods
  • Fats
  • Sugars
  • Following surgery, people with UC should avoid the following foods as they may increase the risk for kidney stones:
  • Spinach
  • Rhubarb
  • Beets
  • Coffee
  • Tea
  • Diet sodas
  • Chocolate

 

Prognosis and Complications

If left untreated, people with UC can develop a wide range of chronic, sometimes dangerous complications. Fortunately, however, most of these complications can be treated successfully. They include:

  • Hemorrhage (abnormal bleeding)
  • Perforation of the colon
  • Narrowing of the colon, which may cause obstruction
  • Abscesses (pus-filled pockets of infection) in the colon
  • Toxic megacolon (grossly swollen colon that may rupture)
  • Colon cancer
  • Nutritional problems (including weight loss and reduced muscle mass)
  • Joint pain and arthritis (such as ankylosing spondylitis)
  • Skin rashes, including erythema nodosum
  • Eye infections/inflammation including uveitis
  • Mouth ulcers
  • Liver damage
  • Blood clots
  • Depression and anxiety

Although there is no complete cure for UC other than surgical removal of the colon, many people with the disease lead active lives by controlling their symptoms with medication. In fact, drug treatment is effective for about 70% to 80% of all people with the condition. About 45% of all people with UC are free of symptoms at any given time, but most suffer at least one relapse in any 10-year period. Although extensive research is still needed in the area of complementary and alternative medicine for UC, preliminary studies indicate that lifestyle changes, including stress reduction, dietary adjustments, and mind/body techniques can work well with conventional therapies to help prevent and/or treat the disease.

 

 

Acne

Acne

What-Is-Acne-and-Causes-Acne

Acne is a skin condition that affects areas containing the largest oil glands, including the nose, forehead, cheeks, chin, back, and trunk. It is caused by a disorder of the oil glands that results in clogged pores and outbreaks of lesions commonly known as pimples. Acne affects between 17 million and 45 million people, making it the most common skin disease in the United States. While it tends to last longer in females, males are more likely to get acne and tend to have more severe cases than do females. Some infants may develop acne, but it is most common in adolescents and it generally disappears by age 30. Although it is not a serious health threat, severe acne can be painful and may cause permanent scarring, which can be upsetting for people who suffer from the condition. An estimated $100 million is spent annually on over-the-counter products to treat acne and reduce the pain, scarring, and emotional distress that can be associated with it.

Signs and Symptoms

There are various types of acne lesions:

  • Comedone — general term for an enlarged hair follicle plugged with oil and bacteria. This is the first and smallest type of lesion. It is often referred to as a microcomendone because it cannot be seen by the naked eye.
  • Open comedone (blackhead) — a plugged follicle that reaches the surface of the skin. Although dark in appearance, blackheads do not indicate the presence of dirt.
  • Closed comedone (whitehead) — a clogged follicle that stays beneath the skin. Whiteheads usually appear on the skin as round, white bumps roughly 1 to 2 mm in diameter.
  • Papules — inflamed lesions that appear as small, pink bumps on the skin
  • Pustules (pimples) — inflamed pus-filled lesions that are red at the base
  • Cysts and nodules — large, inflamed, pus-filled lesions that are lodged deep and can drain, causing pain and scarring

Lesions can cause scars ranging from small, depressed pits to large elevated blemishes, depending on the severity of the condition and the individual’s skin type.

Causes

Acne is a disorder of the skin’s oil glands. Oil glands make an substance called sebum that normally rises up through a hair-containing canal called a follicle and empties onto the skin surface. The precise cause of acne in newborns is not known, but some researchers speculate that it may be due to the transfer through the placenta of hormones from the mother or of acne-causing medication (such as lithium and phenytoin) that the mother may have been taking. During adolescence, rising hormone levels are thought to increase the number of oil glands and the amount of sebum they produce. The increased production of sebum causes blockage of hair follicles, leading to the formation of small bacteria-filled cysts called comedones. If these comedones remain intact and no not rupture, they can progress into open comedones (whiteheads) or closed comedones (blackheads). When comedones rupture, an inflammatory reaction occurs and can spread into the surrounding tissue. Papules, pustules, cysts, and nodules are all forms of inflammatory lesions.

Risk Factors

The following may cause or worsen acne:

  • Family history of acne
  • Greasy/oily cosmetic or hair products containing vegetable or animal fats
  • Hormonal changes associated with adolescence, pregnancy, or menstruation (acne tends to flare up 2 to 7 days before menstruation begins)
  • Certain medications such as corticosteroids, androgens, oral contraceptives, lithium, halogens, isoniazid, phenytoin, phenobarbital, and high levels of iodine (such as from kelp)
  • Environmental irritants such as industrial cutting oils, tar, wood preservatives, sealing compounds, and other pollutants
  • Sweating and friction, such as from headbands, back packs, bicycle helmets, or tight collars
  • High levels of humidity
  • Squeezing and picking comedones

Although still controversial, some researchers believe that stress and sun exposure can also cause or aggravate existing acne. This may be due to the use of oily sunscreens however, as some people with acne actually experience improvement in symptoms with exposure to the sun.

Diagnosis

Acne has a characteristic appearance and is not difficult to diagnose. General practitioners, pediatricians, and internists can treat most individuals with mild and moderate forms of acne. People with more severe cases of acne however, are often referred to a dermatologist or a skin disease specialist. The practitioner will take a complete medical history that includes questions about skin care, cosmetic use, and diet; factors that trigger flare-ups; medication use; occupational and environmental exposures; and prior treatment. The practitioner will also examine the face, chest, back, and other areas for blemishes, lesions, and scars. Several factors, including the size of the blemishes and whether or not they are inflamed, help a practitioner determine the most appropriate treatment.

Treatment Approach

 

670px-Get-Rid-of-Acne-Step-9-Version-3

The main goals of acne treatment are to prevent scarring, reduce the number of painful lesions, and minimize the stress and embarrassment related to the condition. The basic principle of skin care is to wash the affected area no more than one to two times per day with a mild, nondrying soap. Frequent washing and the use of harsh soaps can actually make the condition worse. Healthcare practitioners will often recommend topical medications as their first choice for treating acne (generally either benzoyl peroxide or a class of drugs known as retinoids). These are designed to wear away the top layer of skin (exfoliate) as well as to reduce abnormal clumping of cells in the follicles, oil and bacteria production, and inflammation. Additionally, facial steaming with accompanying manual extraction of the comedones (such as by a professional aesthetician) is valuable for exfoliation as well. Although more research is needed to investigate the safety and effectiveness of alternative remedies for acne, people with mild cases of acne may experience an improvement in symptoms from herbs, Ayurveda, or homeopathy. Mind/body techniques such as biofeedback or hypnosis may also help to alleviate feelings of anxiety and depression that some individuals experience with this skin condition. Expect to use medications and/or complementary and alternative remedies for at least 6 to 8 weeks before seeing a noticeable improvement in symptoms. Seek medical care if infantile acne does not improve within three months.

Rheumatoid Arthritis – Introduction

Rheumatoid arthritis (RA) is a chronic disease of unknown cause affecting over 2 million adults in the USA . An inflammatory disease of the synovium, it results in pain, stiffness, swelling, deformity and, eventually, loss of function in the joints. Because there is currently no known cure or means of preventing RA, the American College of Rheumatology recommends the earliest possible diagnosis and treatment with disease-modifying anti-rheumatic agents to limit the degree of irreversible joint damage . Despite early detection, current treatment medications are limited in their efficacy and are frequently toxic.

Rheumatoid-Arthritis-Therapeutics-Market

Many patients look for complementary and alternative medicine (CAM) options in coping with this debilitating disease. Research has indicated that people suffering from chronic pain, as in RA, and those dissatisfied with current treatment are very likely to seek alternative treatments, and an estimated 60–90% of persons with arthritis use CAM . Among the most widely used treatments are chiropractic and herbal therapies . This growing interest in alternative medical practices clearly indicates the need for more thorough investigation into the safety and efficacy of CAM. An earlier review conducted in 2000 was limited in that it excluded trials of herbal preparations against active comparators.

Lifestyle Changes

Improving your diet using a combination of my nutritional guidelines and nutritional typing. There are some general principles that seem to hold true for all nutritional types and these include:

Eliminating sugar and most grains

Having unprocessed, high-quality foods, organic and locally grown if possible

Eating your food as close to raw as possible

Getting plenty high-quality animal-based omega-3 fats, such as krill oil

Incorporating regular exercise into your daily schedule.

Address Emotional Trauma

Having an effective method to address the nearly universal underlying emotional distresses that are present in virtually all autoimmune diseases like RA.
The emotional trauma typically occurs before the age the conscious mind is formed, which is typically around the age of 5 or 6, though it can occur at any point in your life.

If that specific emotional insult is not addressed with an effective treatment modality, then the underlying emotional trigger will not be removed, allowing the destructive process to proceed.

In some cases, RA appears to be caused by an infection, and it is my experience that this infection is usually acquired when you have a stressful event that causes a disruption in your bioelectrical circuits, which then causes an impairment in your immune system.

This impairment predisposes you to developing the initial infection and also contributes to your relative inability to effectively defeat the infection.

Therefore, it’s very important to have an effective tool to address these underlying emotional trauma which can be addressed by Meridian Tapping Technique (MTT).

If you already have RA, the emotional trauma is best treated by a professional.

Resolve Vitamin D Deficiency

Getting your vitamin D levels checked and, if necessary, taking a supplement if you can’t get daily sun exposure. In the thousands of patients I saw it was unusual where a severe vitamin D deficiency was not present.

For refill, contact Dr. Harish Kumar

Sushruta Ayurvedic Health Centre
# 2250. Bovaird Dr. E. Spring Dale Professional Building.
Suite No. 411. Brampton, ON, L6R 0W3. Canada.
email: drharishverma@gmail.com
Website: www.sushruta.com