People on Immunosuppressive Therapies May Be More At Risk for Skin Cancer

Researchers have found patients undergoing treatments that require immunosuppressive drugs may be more susceptible to non-melanoma skin cancers, requiring greater care with their skin treatments.

Inflammatory bowel disease (IBD) patients who are being treated with immunosuppressive medications may be at increased risk for non-melanoma skin cancer, a new U.S. study says. Researchers analyzed data on 26,403 Crohn's disease patients and 26,974 patients with ulcerative colitis in order to evaluate how the use of immunosuppressive and biologic medications to treat IBD affected non-melanoma skin cancer risk.

The study found that the incidence of non-melanoma skin cancer was higher in IBD patients than in a control group. Recent use (within 90 days) of any immunosuppressive medication was associated with greater risk of non-melanoma skin cancer (adjusted odds ratio 3.28), as was recent use of the thiopurine class of immunosuppressive medications (adjusted odds ratio 3.56) and recent use of biologic medications in Crohn's disease patients (adjusted odds ratio 2.07).

Persistent use of any immunosuppressive medication, which was considered use for more than one year, was strongly associated with non-melanoma skin cancer (adjusted odds ratio 4.04), the study authors noted. The association was even stronger with persistent use of thiopurine medications (adjusted odds ratio 4.27). In Crohn's disease, persistent use of biologic medications was also associated with a raised risk (adjusted odds ratio 2.18).

"The increased risk of non-melanoma skin cancer in patients with IBD is likely related to the immunosuppressive medications used to treat the disease, although we can't rule out changes to the immune system itself as a result of IBD as contributing to this risk," said study leader Dr. Millie Long, of the University of North Carolina at Chapel Hill.

Colitis disease

Colitis disease is the term used to described inflammation of the colon. There are a variety of causes of colitis including infections, poor blood supply, and autoimmune reactions.

The colon (large bowel or large intestine) is responsible for collecting and storing the waste products of digestion. It is a long muscular tube that pushes undigested food towards the anus for eventual elimination as a bowel movement. As the liquid mixture of undigested food makes its journey, it mixes with mucus and normal bacteria residing in the colon. As well, water is reabsorbed into the bloodstream, and the feces start to solidify.

The colon is located in the abdominal cavity and is divided into the following parts: the cecum, the ascending colon, the transverse, the descending colon, the sigmoid, the rectum, and the anus. The right colon includes the cecum and ascending colon. The left colon includes the transverse segment to the sigmoid.

The wall of the colon has numerous layers. There is a smooth muscle layer that wraps the outside and is responsible for squeezing the undigested food through the length of the colon. The inner layers, or mucosa, come into contact with the fluid and allow water and electrolyte absorption to help solidify the feces. The mucosal layer is where the colon inflammation occurs and is responsible for the symptoms of colitis.

As with any other organ, the colon has a blood supply with arteries delivering oxygen rich blood and nutrients to it, and veins that drain carbon dioxide and lactic acid from it.


Colitis Causes

Inflammation of the colon can be caused by a variety of illnesses and infections. Some of the most common causes are discussed below.

Infectious Colitis

Viruses and bacteria can cause colon infections. Most are food-borne illnesses or "food poisoning." Common bacterial causes include Shigella, E.Coli, Salmonella and Campylobacter. These infections often present with bloody diarrhea and can cause significant dehydration.

Pseudomembranous colitis is caused by the bacteria Clostridium difficile (C. difficile). This disorder is often seen in patients who have recently been taking antibiotics for an infection. The antibiotic alters the normal bacteria present in the colon and allows an overgrowth of the Clostridium bacteria. Clostridium bacteria produce a toxin that causes diarrhea. This is an infection, and often there is a fever present. The diarrhea is usually not bloody.

Ulcerative colitis treament testimonial

Change The Way You Move - Arthritis

Arthritis treatment with Flextiva

FLEXTIVA® is a major breakthrough in arthritis treatment, stamping out inflammation, rebuilding cartilage, joint space narrowing, and as a popular alternative treatment for joint pain. It's use is therapeutic and is 100% safe. It's remarkable ability to inhibit inflammation at the joint level is astounding.

Below, we provide brief descriptions of the key ingredients found in FLEXTIVA® and their supporting effects.

The introduction of Aloe Mucilaginous Polysaccharides (AMP) to FLEXTIVA® was a remarkable breakthrough for its success on the battle against joint pain. Aloe mucilaginous polysaccharides are long chain molecules, composed of individual mannose and glucose molecules connected together. These molecules are extracted from the inner gel of aloe vera, by way of lyophilization. FLEXTIVA® is the only joint pain dietary supplement to contain this beneficial compound, making it a highly effective and sought out alternative to non-steroidal anti-inflammatory drugs. When taken on a consistent basis, Aloe Mucilaginous Polysaccharides control the arthritic inflammation of the lining of the joints and reinforces the body's immune system.

One of the many proprietary anti-inflammatory compounds of FLEXTIVA®, Boswellia (boswellia serrata), has long been recognized in medicine for its anti-inflammatory benefits. Today, scientists studying extracts of boswellia are reporting that it can switch off key cell signalers and pro-inflammatory mediators known as cytokines in the inflammatory cascade.1

With the help of MSM (methylsulfonylmethane) as a second layer for anti-inflammatory benefit, FLEXTIVA® is able to suppress pain and improve physical function.2

Bromelain, a natural occurring source, can be beneficial in a vast array of medical conditions. It was first introduced in 1957 and works by blocking proinflammatory metabolites that accelerate and worsen the inflammatory process. It is an anti-inflammatory agent, and therefore can be used in sports injury, trauma, arthritis, and other kinds of swelling. It's main uses are athletic injury, digestive problems, osteoarthritis of the knee3, and aiding healing after surgery.

Glucosamine (glucosamine sulfate) is an important building block in healthy cartilage, and as we age, our bodies cannot create these compounds as readily. The glucosamine found in FLEXTIVA® may help repair damaged tissues, however, it's principle role is to delay the progression of joint inflammation and alleviating its symptoms.

There have been multiple clinical trials of glucosamine as a medical therapy for osteoarthritis and the results have been eye-opening. One three year trial4, with at least 202 patients, demonstrated clear benefit for glucosamine as a treatment. There was not only an improvement in symptoms but also an improvement in joint space narrowing on radiographs. This suggests that FLEXTIVA®, unlike pain relievers such as NSAIDs, can actually help prevent the destruction of cartilage that is the hallmark of osteoarthritis, without nasty side-effects, and possibly determining disease modification.

Diverticulitis treatment

Diverticulitis treatment depends on the severity of symptoms and how many acute episodes the patient has experienced. If symptoms are mild, a liquid or low-fiber diet and antibiotics may be recommended. Those at risk of complications, or who experience recurrent attacks of diverticulitis, may require surgery to remove the diseased portion of the colon.

Self-Care

If diverticulitis is treatable at home, patients should expect to remain quiet for a few days. Antibiotics will be prescribed to help kill the bacteria causing the infection. Patients will also temporarily need to avoid all whole grains, fruits and vegetables, so the colon can rest and heal. Once symptoms improve (often in 2 to 4 days) patients can gradually start increasing the amount of high-fiber foods in their diet.

Hospitalization

About half of those who have diverticulitis require hospitalization and many need intravenous antibiotics. People may need to be hospitalized for vomiting, a fever above 100 degrees Fahrenheit, a high white blood cell count, or high risk of a bowel obstruction, peritonitis or other complications.

Surgery

Two procedures are used to treat serious cases of diverticulitis. They are performed by surgeons who have completed training in both general surgery and colon and rectal surgery.

Primary Bowel Resection (also called Sigmoid Resection or Segmental Resection)
In this procedure the surgeon removes the diseased part of the intestine and then reconnects the healthy segments of the colon (called anastomosis). This allows the patient to have normal bowel movements. Depending upon the patient's condition, laparoscopic methods may be used in place of traditional surgery. Laparoscopic procedures usually require smaller incisions and enable a faster recovery for the patient.

Bowel Resection with Colostomy

Surgeons use the bowel resection with colostomy procedure (also called Hartmann's procedure) when the colon becomes so inflamed that it is not safe to rejoin the colon and rectum. Surgeons only perform this procedure when the patient experiences a life-threatening infection. The colostomy is usually temporary until the infection and inflammation clear.

To create a colostomy, the surgeon makes an opening in the abdominal wall. The colon is then brought out through the opening, and waste passes through the opening into a bag. A colostomy may be temporary or permanent. Once the inflammation has healed, perhaps several months later, the surgeon may be able to perform a second operation to reconnect the colon and rectum.

Treatment of Colitis

Standard ulcerative colitis treatment depends on extent of involvement and disease severity. The goal is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse of the disease. The concept of induction of remission and maintenance of remission is very important. The medications used to induce and maintain a remission somewhat overlap, but the treatments are different. Physicians first direct treatment to inducing a remission which involves relief of symptoms and mucosal healing of the lining of the colon and then longer term treatment to maintain the remission.

Drugs used

Aminosalicylates
Mesalazine, also known as 5-aminosalicylic acid, 5-ASA, Asacol, Pentasa and Mesalamine.
Sulfasalazine, also known as Azulfidine.
Balsalazide, also known as Colazal.
Olsalazine, also known as Dipentum.
Corticosteroids
Cortisone
Prednisone
Prednisolone
Hydrocortisone
Methylprednisolone
Budesonide
Immunosuppressive drugs
Mercaptopurine, also known as 6-Mercaptopurine, 6-MP and Purinethiol.
Azathioprine, also known as Imuran (US) or Azasan, which metabolises to 6-MP.
Methotrexate, which inhibits folic acid
Biological treatment
Infliximab

Alternative Treatments

Aloe Mucilaginous Polysaccharides

Aloe mucilaginous polysaccharides are long-chain sugar molecules composed of individual mannose and glucose sugar molecules connected together — which have been attributed to subduing and reducing symptoms associated with ulcerative colitis.
We recommend SEROVERA® AMP 500. SEROVERA® AMP 500 is a GI-specific supplement that has been used with great success by individuals with UC.

Avoid Swimming Pools if You Have Allergies or Asthma

Swimming in a chlorinated pool may boost the odds that a child susceptible to asthma and allergies will develop these problems.

Chlorinated pools irritate the airways of swimmers, exerting a strong additive effect on the development of asthma and respiratory allergies such as hay fever and allergic rhinitis.

The impact of chlorinated pools on the respiratory health of children and adolescents appears to be much more important -- at least by a factor of five -- than that associated with secondhand smoke.

Source: MSNBC September 15, 2009