Advancements in treatment of Ulcerative Coltis

With all of the rapid innovation in medicine including genetic testing, genetic editing through Crisper, microbiome testing, potential future microbiome specific medications, different monoclonal antibody treatments, mRNA treatments, surgical advancements, and so much more, I wonder if we will see any type of new major development (or currently are and I am unaware) in the treatment and ideally cure of Ulcerative Colitis.

Is there anything in particular people in this forum have been following that they believe has the most promise in treatment of Ulcerative Colitis? What do you see as the most promising in the next 5-10 years? Or, alternatively, has there been any recent major advancement that you have heard of that you particularly believe in? Or, another alternative, any new surgical advancements which might make UC easier to manage? I always wished that surgeons could find a way to remove UC without removing the entire colon but, as far as I know, they still remove the entire colon and connect the small intestine to the anus (even for those who have colitis only in their rectum for example or only on the left side).

I think diagnostics will get better, but treatments won't. They are so focused on the profitable biologics track that it seems like they're going to stay that way for a long time. The people doing alternative work, like with bacteriophages, gene therapy, stem cell therapy, the Crohn's MAP vaccine, FMT, etc... are considered "fringe" by the mainstream despite having some really good evidence. Why are all the best alternative treatments outside of North America and Europe?

Sorry, I take a cynical view of modern medicine in the west. After watching videos of conferences of where big pharma CEOs actually talked about the cure rate hindering the profit model, I don't think cures will be coming anytime soon. There have already been some promising avenues swept under the rug.

The fact that refractory patients have to choose between low quality life or having their colon removed shows the lack of advancement in this field of medicine. Nothing against ostomites whatsoever!... mad respect for anyone who has had to go through with it. I'm talking about the barbaric nature of having to make that choice at all.

Modern medicine can do so much better, they just won't.

They have been doing stem cell therapy in Belgium and the Netherlands (i.e. europe) for extreme cases of crohn's disease (e.g. peope who are unable to eat any more or have too little bowel left for surgery). The problem is that they have to totally re-set your immune system with chemotherapy which makes it very dangerous because you have no immunity to infections and the risk of dying is substantial ... on the other hand, when it has been successful then patients seem to be "cured", i.e. no symptoms and no medicationa required for years after therapy.
I asked my doctor if i could be a candidate (they do it at my hospital); he said no because it was safer to get a colectomy.
Hopefully FMT can be better refined in the future as well (again, trials are still ongoing in Europe, hardly a fringe therapy).
One day maybe they can grow us new colons....but i doubt that will happen in the next decade (or 5!)

Modern medicine does amazing things. I would already be without a colon if I'd flared just one year earlier than I did (i was one of the first patients in Europe on xeljanz for UC after it was licensed in 2018). I've made myself very sick trying "alternative" medicines and won't be going down that path again.
Try to look at the world with a more global perspective. The drugs industry needs an overhaul for sure, but that does not mean that there are not thousands of academic doctors around the world doing ground breaking research and transforming lives. UC is just one of many many illnesses, unfortunately. Research costs money and takes a very long time. Unless we as individual are willing to pay higher taxes to support that, I can't see things going faster.

The other thing I wanted to add is, IBD rates are skyrocketing around the world. So it's not just genetics. It's probably something to do with the way modern humans are living. Pollution, contamination, stress, poor nutrition. Countries that had very low IBD rates before industrialization got them very high after. China is a good example.

Modern medicine is part and parcel with the capitalist industrial complex because they will never admit that things like pollution and pesticides are destroying people's guts. For anyone in power to admit that would mean our entire system would need to be overhauled. So for now they just have to act like they "don't know" while they don't investigate some very obvious root causes.

Post Edited (VanJordan) : 3/18/2021 8:23:24 AM (GMT-6)

I keep thinking the answer must lie somewhere along the same lines as h pylori. Look at how many years they said stomach ulcers were caused by stress until they finally discovered the h pylori. We have ulcers in our guts so makes sense that some kind of bacterium is causing it. Problem is trying to find it. And then a cure.

The microbial angle is definitely the most promising in my opinion - whether its lack of a good microbiome strain or the need to remove a pathogenic microbiome stain.

I found this as a new potential microbiome treatment but seems its in kind of an early stage: https://www.finchtherapeutics.com/pipeline/#fin524

FlowersGal said...
I keep thinking the answer must lie somewhere along the same lines as h pylori. Look at how many years they said stomach ulcers were caused by stress until they finally discovered the h pylori. We have ulcers in our guts so makes sense that some kind of bacterium is causing it. Problem is trying to find it. And then a cure.