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Can ulcerative colitis be cured?

Q: I am a 41 years old male suffering from ulcerative colitis for the last 12 years. I have been taking Predone 10 mg for the last 10 years as everything else failed. This has kept me stable. From the last one year, I have reduced the dose of Predone to 5 mg. There is no blood in the stool and I do not have any cramps but I have a very urgent need to pass stools at least 12 times daily. The need to pass stools is very urgent and cannot be controlled. I have lost 10 kg weight in the last year and constantly feel fatigued and tired; my haemoglobin remains constant at 8 gm. The stool is semi-solid; looks dark and semi-digested food can be seen in the stool. Can ulcerative colitis be permanently treated?

A:From your note I realise that you have been suffering from ulcerative colitis for ten years and that you have been taking prednisolone (a steroid) 10 mg / 5 mg every day. Your haemoglobin is 8 gm, which is only 60% of what it should be and therefore you are anaemic, meaning, there is a gradual blood loss with diarrhoea and/or your marrow response is not adequate enough to make the blood up to 100%. Thirdly you have lost weight.

Ulcerative colitis a chronic condition and Prednisolone only helps in acute relapses and does not maintain remission. So you should have been on medication called 5-ASA available as tablets / suppositories and these can be used for long periods to maintain remission, using prednisolone only when a relapse occurs. You need to consult a gastroenterologist for colonoscopy, multiple biopsies to assess the extent of colon affected and organise treatment as needed. As you might have been informed there is a risk of cancerous changes in the lining of the bowel after about ten years of the disease and this further warrants a colonoscopy and biopsies. You need to be on medication for your anaemia and treated as appropriate. Finally it is possible that your problem may be only in the rectum which will fit in with your symptom of urgency and suppositories are very helpful form of medication.

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