Can biologics and diet help in managing ulcerative colitis?

Question

Hi doctor,

I am 34 years old and have been living with ulcerative colitis for the past four years, primarily affecting the left side of my colon. I am currently taking Mesalamine, but I have experienced two flares this year with symptoms of rectal bleeding and urgency. My gastroenterologist is now recommending that I start treatment with either Infliximab or Vedolizumab. How should I decide between these biologic therapies?

Are these medications considered safe during pregnancy and breastfeeding? Will I need to stay on biologics indefinitely, or is it possible to taper off them at some point? How frequently should I undergo colonoscopies to screen for colorectal cancer? Do probiotics or dietary modifications have any real benefit in reducing inflammation?

I am also concerned about the long-term effects of steroid use. Are rectal therapies an option for long-term maintenance treatment? Lastly, how can I effectively manage stress to help prevent flares? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Choosing between Infliximab and Vedolizumab depends on several factors, including:

Disease severity:

Your gastroenterologist will evaluate the extent and activity of your condition.

Previous treatments:

Your response to earlier medications will help guide the decision.

Side effects:

The potential risks and benefits of each biologic therapy will be considered.

Pregnancy and breastfeeding:

Both Infliximab and Vedolizumab have been studied in pregnancy and during breastfeeding. However, it is important to consult your healthcare provider for individualized recommendations.

Treatment duration:

Biologic therapies are often used as long-term treatments. In some cases, tapering may be possible under close medical supervision.

Colonoscopies:

The frequency of colonoscopy (a medical procedure where a flexible, lighted tube with a camera (colonoscope) is inserted into the rectum to examine the lining of the colon (large intestine) and rectum) screening depends on the severity and duration of your disease, as well as your family history of colorectal cancer (a type of cancer that develops in the colon or rectum). Your gastroenterologist will recommend an appropriate surveillance schedule.

Probiotics and dietary changes:

Some studies suggest that certain probiotics and dietary modifications may help reduce inflammation. However, their effectiveness can vary between individuals. It is best to discuss these options with your gastroenterologist or a registered dietitian.

Rectal therapies:

Rectal medications may be used for maintenance therapy or during flares, especially in cases of left-sided ulcerative colitis. Their use will depend on the location and severity of your disease.

Stress management:

Practices such as meditation, yoga, deep breathing exercises, and mindfulness techniques may help reduce stress, which can sometimes trigger flares.

Consult your gastroenterologist to make informed decisions about your treatment plan based on your individual health needs.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.