What are the treatments for inflammatory bowel disease (IBD)?

Inflammatory Bowel Disease (IBD) is a disease with chronic intestinal inflammation as its main clinical feature, including Crohn's disease and ulcerative colitis. According to the current clinical research on the disease, IBD can be treated with general anti-inflammatory drugs, immunomodulators, biological agents and other drug treatments, or surgical treatment for patients with more severe IBD. However, whether it is drug treatment or other treatment methods, the right medicine must be used to improve the effectiveness of patient treatment. So let's talk about what treatments are there for inflammatory bowel disease (IBD)? I hope it will be helpful to you.

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1. Commonly used drugs for inflammatory bowel disease (IBD) - over-the-counter drugs (OTC)

1. Drugs for controlling inflammatory response

One of the main characteristics of inflammatory bowel disease is the persistence of inflammatory response. In order to relieve symptoms, some over-the-counter drugs can play a therapeutic role by inhibiting inflammatory response. Among them, nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used drugs. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that can inhibit inflammatory response. They reduce the pain and discomfort caused by inflammation by inhibiting the activity of an enzyme called cyclooxygenase. Common over-the-counter NSAIDs include ibuprofen and aspirin, which can help relieve abdominal pain and discomfort caused by inflammatory bowel disease.

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2. Drugs that regulate the immune system

Inflammatory bowel disease is the result of an abnormal response of the immune system, so some over-the-counter medications can reduce symptoms by regulating the immune system. Among them, probiotics are a commonly used drug choice.

Probiotics are microorganisms that are beneficial to intestinal health. They can regulate the balance of intestinal flora and improve intestinal immune function. Studies have shown that the intake of probiotics can reduce the frequency and severity of inflammatory bowel disease. They maintain the normal function of the intestine by increasing the number of beneficial flora and inhibiting the growth of harmful flora. Common probiotics include lactic acid bacteria, bifidobacteria, etc.

3. Drugs for relieving indigestion

Inflammatory bowel disease is often accompanied by indigestion symptoms. Antacids and H2 blockers can help patients relieve these symptoms.

Antacids and H2 receptor antagonists can reduce the secretion of gastric acid, thereby relieving stomach pain and indigestion. They work through different mechanisms. Antacids mainly relieve stomach pain and acid reflux by neutralizing gastric acid, while H2 receptor antagonists achieve the same effect by inhibiting the production of gastric acid. The use of antacids and H2 receptor antagonists should be carried out under the guidance of a doctor, and the appropriate drug and dosage should be selected according to individual differences and conditions. Different drugs may have different side effects and contraindications, so you should read the drug instructions carefully before use and consult your doctor.

4. Drugs that repair the intestinal mucosal barrier

Inflammatory bowel disease damages the intestinal mucosal barrier, allowing toxins and bacteria to penetrate, leading to inflammation and other symptoms. Various over-the-counter medications can be used to help repair this barrier and enhance mucosal barrier function.

Intestinal barrier protectants are a class of commonly used drugs that can enhance the integrity of the intestinal mucosal barrier and reduce the penetration of toxins and bacteria. These drugs usually contain some active ingredients, such as peptides and amino acids, which can promote the growth and repair of intestinal mucosal cells and increase the stability of the mucosal barrier.

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2. Commonly used drugs for inflammatory bowel disease (IBD) - prescription medications (POMs)

1. Aminosalicylate

Aminosalicylates are a class of anti-inflammatory drugs commonly used to treat mild to moderate inflammatory bowel disease. They relieve the symptoms of inflammatory bowel disease by inhibiting the synthesis and release of inflammatory mediators, reducing the inflammatory response and damage to the intestinal mucosa. They mainly act on the colon and rectum and are particularly effective in treating ulcerative colitis and proctitis.

Common aminosalicylate drugs include 5-aminosalicylic acid, which can be used orally or rectally. It can reduce intestinal inflammation, relieve symptoms such as diarrhea, abdominal pain and rectal inflammation. Or valsartan (Mesalazine), which also has similar anti-inflammatory effects. It is commonly used to treat ulcerative colitis and proctitis, and can be used orally or rectally. In addition, sulfasalazine is a drug commonly used to treat inflammatory bowel diseases (such as ulcerative colitis and Crohn's disease). On the one hand, sulfasalazine reduces the degree and duration of inflammatory response by inhibiting the production and release of inflammatory mediators such as interleukin-1 and tumor necrosis factor-α. On the other hand, sulfasalazine can enhance the barrier function of the intestinal mucosa, reduce the penetration of toxins and harmful substances, and prevent inflammation and damage to intestinal tissue.

Glucocorticoids

Glucocorticosteroids are a class of drugs with potent anti-inflammatory effects that are commonly used to treat acute inflammatory outbreaks and symptom exacerbations of IBD. Glucocorticoids relieve the symptoms of inflammatory bowel disease by suppressing the inflammatory response and immune response of the immune system. They can reduce intestinal inflammation, reduce damage and infiltration of the intestinal mucosa, and inhibit the synthesis and release of inflammatory mediators. Common glucocorticoid drugs include prednisone, which can be used orally or by injection. It has a potent anti-inflammatory effect and can quickly relieve the symptoms of inflammatory bowel disease. And prednisolone, which is an active metabolite of prednisone and has similar anti-inflammatory effects to prednisone. It is also commonly used to treat acute inflammatory outbreaks and symptom exacerbations.

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3. Immunosuppressants

Immunosuppressants can relieve the symptoms of inflammatory bowel disease and control the progression of the disease by regulating the function of the immune system. Common immunosuppressants include methotrexate, which is an immunosuppressant that interferes with cell DNA synthesis and immune cell proliferation. It is often used to treat refractory inflammatory bowel disease or patients who are intolerant to other drugs.

4. Biological agents

Biologics are a class of drugs obtained through genetic engineering technology that can intervene by targeting specific molecules in the immune system, thereby alleviating the symptoms of inflammatory bowel disease and controlling the progression of the disease.

Common biologic drugs used to treat inflammatory bowel disease include anti-tumor necrosis factor (Anti-TNF) drugs: such as infliximab, adalimumab, and golimumab. These drugs can inhibit the activity of tumor necrosis factor (TNF), reduce inflammatory responses and immune-mediated damage. They are commonly used to treat moderate to severe inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. However, the use of biologics requires close monitoring and the guidance of a doctor. When using these drugs, some side effects may occur, such as immunosuppression, increased risk of infection, allergic reactions, etc. Therefore, patients need to undergo regular blood tests and other related tests to ensure the efficacy and safety of the drugs.

5. Antibiotics

In addition to biologics, antibiotics are also commonly prescribed drugs. Antibiotics can be used to control the symptoms of inflammatory bowel disease and reduce the progression of the disease. Common antibiotic drugs include:

Fluoroquinolone antibiotics: such as ofloxacin and ciprofloxacin. These drugs can reduce bacterial infection and inflammation in the intestine by inhibiting bacterial DNA synthesis and cell division. They are commonly used to treat acute attacks of Crohn's disease and ulcerative colitis and to maintain remission.

Nitroimidazole antibiotics: such as metronidazole, tinidazole, etc. Nitroimidazole antibiotics have certain antioxidant effects, which can inhibit the endogenous oxidative stress response of bacteria and reduce the sensitivity of bacteria to oxygen free radicals, thereby protecting bacteria from oxidative damage. In addition, this type of drug can also inhibit the bacteria from producing and releasing some virulence factors that are harmful to the host, such as endotoxins, lysozymes, etc., thereby reducing the damage of bacteria to the host.

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In short, for inflammatory bowel disease, the choice of drug treatment ultimately needs to be based on one's own actual situation, after consulting a doctor, and using the drug rationally, so as to improve the effectiveness of drug treatment.