HealingWell
Search Close Search
☰

Long-term inflammation versus "Big Gun" medicine

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/30/2015 2:18 PM (GMT 0)
I suffered a flare in December after almost three years of "remission." I got better after one month but still have minor inflammation (had a colonoscopy earlier this month). I also showed potential minor inflammation with another colonoscopy two years ago. I currently have only minor symptoms such as loose stools and using the restroom slightly more than normal.

My question: It seems like I continue to have minor inflammation in the lower colon, even with using Asacol, Rowasa and Canasa. Is it better to have minor inflammation with no symptoms or should one think about going to another level of medicine (immune suppressants or biologics) to potentially stop the inflammation?

I worry about the inflammation leading to something more serious such as cancer, a bigger flare or for my UC to begin extending further up the colon. Of course, I also worry about the small potential for side effects from the "bigger gun" medicines as well.

What are your thoughts?
Posted 1/30/2015 2:34 PM (GMT 0)
good question - have you made any changes to your diet/life since you were dx'd ? that's the direction i would look first - also, i think age is a big factor in the decision making process -
Posted 1/30/2015 2:41 PM (GMT 0)
juststud, the only diet I have tried was the SCD diet. I stopped it after one month though as I lost too much weight on it. Lately I have been trying to eat lots of anti-inflammatory foods including ginger and tumeric.
Posted 1/30/2015 2:41 PM (GMT 0)
Tough one. It's true that chronic inflammation can lead to cancer but it is also true that mesalamines are anti-inflammatory and help prevent cancer.

You can try diet modification to dampen down inflammation. I personally find that some foods like gluten cause bleeding for me.

I question the value of immunosuppressants unless they are absolutely necessary. First of all there is no guarantee that they will completely snuff out your internal fires, and you might be opening up a can of worms by suppressing your immune system.
Posted 1/30/2015 2:47 PM (GMT 0)
You raise an interesting concern. I think cancer risk truly varies from person to person, and genetics might play some part.

However, I think the paradigm on cancer and disease is changing rapidly to acknowledge the role of environmental stressors.

Some new data would suggest that epigenetics plays more of a role than previously thought. Environmental factors like lifestyle, diet, stress do indeed affect the risk, though the percentage is unknown.

It is entirely within the realm of possibility for one to reduce their risk. Nothing is ever set in stone. We know for instance that legumes and resistant starches reduce colon cancer risk. Things like chronic stress (and inflammation) can also turn genes on and off.

It is also possible for one to build up their microbiome to mitigate the risk, since both colon cancer and IBD are linked to poor bacterial diversity.

I invite you to look into the new studies on resistant starches - things like prebiotics, probiotics all play some part in healing the colon. Stress reduction and proper sleep are perhaps the most important.

Best.

Post Edited (Guardian7) : 1/30/2015 7:56:21 AM (GMT-7)

Posted 1/30/2015 2:51 PM (GMT 0)
yep, i would continue what you are doing, but think about restricting or removing typical inflammatory foods - nothing crazy, just baby steps -
Posted 1/30/2015 3:45 PM (GMT 0)
I agree with the previous posters. It took me a long time to get my remission, and my DRs and I discussed different meds fairly often.

I did deploy steroids twice in my treatment - one time because I developed all-over body joint pain and needed 60 mg of pred to relieve that, and then I used entocort as a follow-up to really solidify the remission.

I adopted a GF diet which relieved the remaining symptoms I was having. Last thing was to add psyllium to replace the whole grains I lost going GF.

I also take vitamin D and flax seed oil daily (omega 3). Are you taking vitamin D and an omega 3? You should be if you are not already.
Posted 1/30/2015 3:55 PM (GMT 0)
I would not want low grade inflammation. You have absolutely no idea where it will peek out, not necessarily cancer but somewhere else that may require a complete different set of meds, complicating the situation.

Try out various approaches. You never know what will work, unless you give it a try.

I am going gut flora way, but that may not be the best solution for everyone.
Do you have any resistant starch in your diet? Consider looking into it.
Posted 1/30/2015 4:13 PM (GMT 0)
I would consider diet more but I don't mean a name brand diet. Find out foods that bother you. Find out if there are any foods that are good for you. Check into various supplements that might improve your condition. Make your own diet plan, don't follow some name brand diet. There is no such thing as a UC diet. You have to make your own.
Posted 1/30/2015 4:33 PM (GMT 0)
Good suggestions to look at your body holistically and try to reduce inflammation as a whole. This will bring benefits even beyond your colon and extend your life (proven by many studies).

1. Eat less meat (esp. red meat) and eat more plants including veggie juice.
2. Add anti-inflammatory foods into your food (ginger, garlic, turmeric, oregano, chocolate, etc)
3. Eat less sugar, that means no sodas, less candy, etc.
4. Eat less manufactured food which has preservatives and many inflammatory ingredients hidden
5. Use olive oil whenever possible, it is anti-inflammatory along with coconut oil
6. Try and remove stress (or reduce it as much as possible) to keep your body calmer
7. Consider going gluten-free because wheat is inflammatory even if you show no symptoms of intolerance.

There are many other foods I could add but many are gut-driven and different for everyone.
For example eating nuts is good but my gut can't handle the fiber, psyllium is good but ditto, red wine in moderation is good but my gut hates it, small amount of fruit is good including tomatoes, ditto again.

Not everything must be done immediately or at all. It's a process. When my gut was flaring horribly I had to eat red meat because it was beloved by my gut. Now I'm cutting back to 3 oz. of red meat a week and it's not hard at all. Stir fry dinners with chicken, ginger and lots of veggies is yummy. Many Asian cuisines use meat as an accessory not the entree.
Posted 1/30/2015 4:50 PM (GMT 0)
Untreated uc inflammation over prolonged time periods put you at much greater colorectal cancer risk than the average population (where as being free of inflammation puts you at the same risk as the general population). Inflamed tissue can show signs of dysplasia (precancerous) and cost you your large intestine. If it doesn't become cancerous, then other things are possible: scaring, thickening of the intestinal walls (causing pain, and difficulty pooping), and other such things.

Simmering inflammation makes it more likely your uc will spread in extent and severity. It also increases your odds of flares. Those without inflammation have less frequent flares.

So, yes I would get a prescription for immunosuppressive meds, without question. And the improvement in quality of life is a bonus, less uc urgency, less bms, and better formed stools. Side effects from immunosuppressive medications is very rare. Lymphoma is in 4 in 10,000 (or 0.04 percent), versus 2 in 10,000 (or 0.02 percent) for the general population. I've read the cancer risks are much, much higher with untreated inflammation, just don't have the odds at my fingertips.
Posted 1/30/2015 5:01 PM (GMT 0)
please be getting those fingertips hopping - lots of folks would like to see those numbers ;-)
Posted 1/30/2015 5:14 PM (GMT 0)

Guardian7 said...

I invite you to look into the new studies on resistant starches - things like prebiotics, probiotics all play some part in healing the colon. Stress reduction and proper sleep are perhaps the most important.

I have never researched much on resistant starch although I have seen it mentioned many times here on HealingWell. I will research further and perhaps give it a try.

I am currently taking VSL#3 and seem to improve while taking it so I am interested in anything that can increase the friendly bacteria in the gut.
Posted 1/30/2015 6:17 PM (GMT 0)
Are your inflammatory markers (C-reactive protein, ESR/sed rate) elevated as well or is the inflammation only detectable from scopes and biopsies?

Personally I tend to agree with those upthread who argue that mild simmering inflammation is a bad thing, but I would take it even more seriously if your blood test results reflect active inflammation as well.
Posted 1/30/2015 6:34 PM (GMT 0)
I've found many statements in journal articles backing my prior statements in generalizations without giving the exact odds. Although I can't get the exact figure on cancer odds of untreated uc inflammation versus well treated. Might be a bit too vague of a question. Might search more later.

Some interesting tid bits:

Does Ulcerative Colitis Cause Cancer?
Most people diagnosed with ulcerative colitis are concerned they will develop colon cancer, but this is rare.
Results—The overall prevalence of CRC in any UC patient, based on 116 studies, was estimated to be 3.7%.

The incidence rates corresponded to cumulative probabilities of 2% by 10 years, 8% by 20 years, and 18% by 30 years.
Source: www.ncbi.nlm.nih.gov/pubmed/11247898
If only your lower colon and rectum are affected by ulcerative colitis, your chances of getting colorectal cancer are similar to the risks of people without ulcerative colitis; however, your risk can rise to 32 times that if your entire colon is affected. Those who get colorectal cancer usually have more of their colon affected by the ulcerative colitis. Source: www.everydayhealth.com/ulcerative-colitis/colorectal-cancer-risk.aspx

This was a very interesting read on the subject:
www.hindawi.com/journals/ulcers/2011/714046/
Posted 1/30/2015 11:18 PM (GMT 0)
Nah, with that little inflammation i wouldnt care for big gun meds at all, just have your colon checked regulary. Besides colon cancer is after all more treatable than t-cell lymphoma
Posted 1/31/2015 12:45 AM (GMT 0)
Actually of the scarce few (4 in 10,000 or 0.04 percent) who get lymphoma from immunosuppressive meds, 60 percent are treated and their cancer goes into remission. The odds of a healthy person getting lymphoma are 2 in 10,000 or 0.02 percent.
Posted 1/31/2015 1:07 AM (GMT 0)
sounds pretty scary to me shocked
Posted 1/31/2015 1:18 AM (GMT 0)
What's much scarier is 1 in 5 of us will die of heart disease. 1 in 100 will die in a car crash, yet we still get in cars each day...
Posted 1/31/2015 1:19 AM (GMT 0)
I've had crohn's inflaming my colon for the last 23 years....it's only gone into remission this last summer...no signs of colon cancer what so ever (my rectum was pretty bad off too and I dealt with proctitis on and off over those 23 years when my colon was continuously inflamed) my rectum even has some scaring as a result, but no rectal cancer either.

I know everyone is different, and their genetic risk for getting any GI cancer should be considered as well, it's not written in stone that just because you do have inflammation in the colon for many many years that you will necessarily end with cancer as a result...I'm also a smoker of over 30 years (smoking more often than not) and still no cancer anywhere for me.
✚ New Topic ✚ Reply