New treatment for ulcerative colitis

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DEAR DR. DONOHUE: I am a 61-year-old man who has been suffering with ulcerative colitis for six years. I had been on many medicines, but none stopped the diarrhea or bleeding. In December of 2005, I said to my doctor that I had had enough and would get the surgery he recommended. He suggested a new drug called Remicade. Lo and behold, after three treatments, I feel like a new man. I am almost like I was when I was 20. My story is worth telling so others can benefit. – M.H.

ANSWER:
With ulcerative colitis, shallow, bleeding ulcers cover the colon lining and bring on diarrhea, often bloody, with painful abdominal cramps.

Its cause is a combination of genetics, a misfiring immune system and some as-yet-identified factor or factors.

The illness strikes at any age, but there are two peak periods, one occurring in the teens and 20s, the other in the 50s and 60s.

Early in the illness, when symptoms are not terribly severe, Pentasa, Asacol and Dipentum are the medicines chosen to heal the colon. If matters progress, the cortisone drugs come to the fore, with prednisone being the one most often prescribed. Other medicines used to calm the inflamed colon are the immune-system-modulating drugs azathioprine and 6-mercaptopurine.

Remicade is a new medicine. It was first used for rheumatoid arthritis and Crohn’s disease, the other inflammatory bowel disease. It neutralizes a body chemical that promotes inflammation in these illnesses. It’s gratifying that Remicade has brought you good health, but not everyone can expect such a transformation. It has some undesirable side effects, one of which is a susceptibility to infection. No truly effective medicine comes without side effects.

DEAR DR. DONOHUE: What are the advantages of a colonoscopy over a sigmoidoscopy? One of my doctors says, “Not much.” The other disagrees, but I don’t know why. – P.W.

ANSWER:
You’re speaking of an exam for the detection of colon cancer, right?

The colon is 5 feet long. Only the colonoscope reaches its entire length, a major advantage. On top of that, doctors can remove polyps and other suspicious growths when using a colonoscope. Colon cancer begins as a polyp.

The longest sigmoidoscope is 2 feet (60 cm). Two-thirds to three-fourths of polyps are found in those two feet, but that does leave at least one-quarter that aren’t in the range of a sigmoidoscope.

I’d choose the colonoscopic exam for cancer screening.

The booklet on colon cancer deals with all matters relating to that topic. Readers can obtain a copy by writing: Dr. Donohue – No. 505, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have been taking lisinopril, simvastatin and felodipine for 10 years. I am 69 years old.

I started dieting. I went from 220 pounds (I am 6 feet, 2 inches tall) to 202 pounds. My blood pressure prior to dieting averaged 120/80 on medicine. Now it averages 105/70. Should I ask my doctor to evaluate this new change or just accept the lower pressure as a bonus? – R.C.

ANSWER:
Your old readings were good; your new ones are even better. It shows you how weight plays such a big role in blood pressure. Tell your doctor. The doctor might lower or change some of your blood pressure medicines. With continued weight loss, you might be able to get off all medicine.

Lisinopril (Zestril) is an ACE inhibitor, and felodipine (Plendil) is a calcium channel antagonist. Both are blood pressure medicines. Simvastatin (Zocor) lowers cholesterol.

DEAR DR. DONOHUE: A few weeks ago, you described motor and sensor neuropathy. Literature my husband has discusses peripheral neuropathy only. What is done for motor neuropathy, which is what my husband has? – E.H.

ANSWER:
Peripheral neuropathy is a term that includes both forms of neuropathy, motor and sensory. Motor neuropathy indicates that nerves to muscles are involved with the process, so movement is impaired – walking. With sensory neuropathy, sensations are affected. People have pain or numbness. Some patients have both sensory and motor neuropathy. The approach to both is found in that literature you have on peripheral neuropathy.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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