What medications are used in the event of a relapse?
Which drugs are used in the relapse depends on the severity of the individual relapse. A mild episode without fever and only a few bloody diarrhoea cases can be treated well in most cases with Salofalk alone. Salofalk® (mesalazine) can be given in the form of tablets or inserted into the rectum as suppositories or foam.
For moderate attacks, which can sometimes be accompanied by fever and a distinct feeling of illness, the therapy is extended with glucocorticoids such as cortisone. Normally, one starts with tablets or local procedures before increasing the therapy further. Glucocorticoids via the vein are used for severe relapses.
The severe relapse is characterized by fever and more than six diarrhea cases per day. The heart rate is also elevated. In severe relapses Salofalk® should be avoided, as it is not possible to achieve a sufficient effect.
If the symptoms do not improve with cortisone alone, various immunosuppressive drugs can be considered. These include the antibody Remicarde® and the group of calcineurin inhibitors. The calcineurin inhibitors inhibit calcineurin, which plays an important role in the activation of inflammatory cells. General information can be found under: Relapse in colitis ulcerosa
What can I do if the medication does not help?
If the drug therapy has been exhausted and no longer yields a profit, surgical therapy should be considered. Ulcerative colitis can even be cured with a so-called proctocolectomy. In this operation the entire colon and additionally the rectum is removed.
As a new reservoir for the stool, a pocket is formed from a part of the small intestine, which is then connected to the anus so that stool continence is still maintained. In order to allow the new connection to heal in peace, an artificial bowel outlet is created over a limited period of time, which can easily be relocated after the healing phase. The operation is not only used when the medication is no longer effective, but also when complications occur.
These are for example a rupture of the intestine or a life-threatening dilatation of the colon. In addition to the operation, there is the possibility of removing the excess immune cells in a kind of dialysis, as these continue to maintain the inflammation. This procedure is used in Germany only in rare individual cases. You can find further information on this topic at: Therapy of ulcerative colitis
