Biologic Therapy Crohns Disease & Ulcerative Colitis

Inflammatory Bowel Disease.  How Do We Induce remission?

Inflammatory bowel  disease (IBD) is actually a group of diseases which predominantly produce symptoms associated with the gastrointestinal tract.  The symptoms may be minor and bothersome.  Or, they may be life threatening.  It is not clear as to why some patients have severe disease and some have minor inconveniences.  The most well known members of the IBD family are Crohn’s disease and ulcerative colitis (U.C.).

What is clear is that inflammatory bowel disease is common, especially in large cities such as Los Angeles, and is one of the most common maladies seen in the office of the colon and rectal surgeon, also known as a proctologist.  There are many therapies to treat this family of disorders.  They range from aspirin related compounds to steroids and chemotherapeutic agents.  One of the most novel and successful forms of treatment are the family of biologic agents.  Finally, when all else fails, surgery may be necessary.

What Are The Symptoms of IBD?

Predominant among the symptoms associated with IBD are:

  • Blood in the stool.
  • Mucus in the stool.
  • Diarrhea.
  • Abdominal pain and bloating.
  • Arthritis.
  • Skin diseases.
  • Ocular (visual) problems.

What Are Biologic Medications And How Do they Work?

Biologics target specific components of the immune system, the system of the body which watches over us and fights off disease.  In the case of IBD, the medications target cytokines, or molecules which are involved in cell signaling.  In essence, the cytokines can tell cells what to do and biologic agents can target and destroy the cytokines.

Although cytokines are a normal part of the immune system, occasionally, the cytokines can turn against the bodily immune system.  One of the cytokines is tumor necrosis factor-alpha (TNF-α), We do not know the exact mechanism by which TNF-α exerts its damaging effects.  However, researchers have found interesting ways to disable TNF-α.

An antibody is a molecule that binds to an antigen, or a target protein.  Infliximab, or Remicade®, is such an antibody.  It is made form a single clone of cells and is therefore called a monoclonal antibody.  It binds to and destroys TNF-α and decreases the intense immune response thought to be responsible for the activation of Crohn’s disease and ulcerative colitis.

There are other monoclonal antibodies which have been developed to blunt or inactivate IBD.  Each has specific uses, works better in certain diseases and has certain side effects.

Side Effects of Monoclonal Antibodies.

No medication is free from risk.  This is certainly true in this class of drugs.  Side effects include:

  • Serious blood disorders.
  • Infections.
  • Liver disease or reactivation of Hepatitis B.
  • Reactivation of tuberculosis.
  • Lymphoma
  • Lupus (an autoimmune disorder).
  • Solid organ cancers.

This class of drugs is a very serious class and is administered under the aegis of experienced physicians.  If these medications fail to halt the progression of disease, operations may be needed.  This is the point at which the colon and rectal surgeon becomes involved.

Los Angeles Colon and Rectal Surgical Associates.

All of the board certified surgeons of Los Angeles Colon and Rectal Surgical Associates have many years of experience surgically treating the ravages of IBD.  Whether the operations involve a total proctocolectomy (removal of the entire colon and rectum), with the creation of an IPAA (ileopouch-anal anastomosis, or new rectum), removal of areas of involved small intestine, treatment of intestinal fistulas (abnormal connections between the intestine and other pieces of intestine), or in the treatment of anal fissures, the surgeons have a complete understanding of the surgical process.

A call to the surgeons at (310)273-2310 will be your first step in surgically treating your IBD.  Your consultation will be confidential and will allow you to become educated about your form of IBD.