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Tuesday, 3 December 2013

Chemical colitis - Treatments in Conventional medicine

Colitis is defined as a condition of inflammation of the large intestine, including the colon, caecum and rectum.
Treatments
A. In conventional medicine perspective
Iatrogenic colitis - Chemical colitis
1. Glutaraldehyde induced colitis presents clinically with severe abdominal pain, bloody and mucoid diarrhea, rectal bleeding, and tenesmus 48-72 h after colonoscopy. Endoscopic findings are nonspecific and mimic ischemic colitis, inflammatory bowel disease, and infectious colitis. According to the study by. the treatment is mainly supportive but sometimes necessitates mesalamine, prednisolone, or metronidazole and the resolution is rapid. In endoscopy units, strict adherence to published disinfection protocols is very important and the cleaning, rinsing and drying protocols also deserve the same attention
a. Mesalamine
Mesalazine (INN, BAN), also known as mesalamine (USAN) or 5-aminosalicylic
acid (5-ASA). In the study to assess the experimental colitis induced by rectal instillation of 2,4,6-trinitrobenzene sulfonic acid (TNBS) into male Wistar rats, found that the loading of 5-ASA into SucCH polymer markedly improved efficacy in the healing of induced colitis in rats(90).

b. Prednisolone and Metronidazole 
Prednisolone is a synthetic form of lucocorticoid,  used to treat a variety of inflammatory and auto-immune conditions and Metronidazole is an antibiotic used to treat bacterial cause of infection in your body.. According to the study by, the treatment is mainly supportive but sometimes necessitates mesalamine, prednisolone, or metronidazole and the resolution is rapid. In endoscopy units, strict adherence to published disinfection protocols is very important and the cleaning, rinsing and drying protocols also deserve the same attention(91).

c. Pregnane X Receptor (PXR)
Pregnane X Receptor (PXR), a master regulator of drug metabolism and inflammation, is abundantly expressed in the gastrointestinal tract. In the study by Albert Einstein College of Medicine,  to investigate the role these flavonoids play in inhibiting gut inflammation by an axis involving PXR and other potential factors, found that Baicalein, but not its glucuronidated metabolite baicalin, activates PXR in a Cdx2-dependent manner in vitro, in human colon carcinoma LS174T cells, and in the murine colon in vivo. While both flavonoids abrogate dextran sodium sulfate (DSS)-mediated colon inflammation in vivo, oral delivery of a potent bacterial β-glucuronidase inhibitor eliminates baicalin's effect on gastrointestinal inflammation by preventing the microbial conversion of baicalin to baicalien(92).

2. Certain chemicals such as TUDCA and PBA alleviate different forms of colitis in mice(93), including inflammatory bowel diseases, Ischemic colitis(94), etc. Treatment of such diseases depending to the development of types of colitis.
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Sources
(90) http://www.ncbi.nlm.nih.gov/pubmed/22815676
(91) http://www.ncbi.nlm.nih.gov/pubmed/19104938
(92) http://www.ncbi.nlm.nih.gov/pubmed/22815676