Mesalazine for Ulcerative Colitis, Side Effects and Better Alternative Treatment Available

ABSTRACT

Inflammatory bowel disease (IBD) has a subcategory called ulcerative colitis which affects many people worldwide. Its main cause remained contradicted but it is said that this disease happened due to genetic or environmental problems. The ayurvedic treatment gives very effective results in these diseases and also helps in reducing the active time of diseases, with minimum side effects than another pathy. In this article, we discussed mesalamine drugs which are highly used in ulcerative colitis patients in modern medicine and the ayurvedic perspective on that.

INTRODUCTION

In IBD patients the most characteristics of chronic inflammatory conditions are ulcerative colitis (UC) and Crohn’s disease. In these two conditions, the common features are diarrhoea, bloody stools, weight loss, abdominal pain, fever and fatigue.

Ulcerative colitis affects the colon and rectum and typically it involves the inner lining which is also known as the mucosa, it also has features like inflammation in the affected area and ulceration with no segmentation present. The most reliable definition of ulcerative colitis comes from The Crohn’s and colitis foundation of America which defined UC as a Disease involving only the most distal part of the colon and rectum. Distal colitis- Disease down from the descending colon. Pancolitis- Disease involving the entire colon.

SIGN AND SYMPTOMS

1. Typically more than 3 episodes of diarrhoea
2. Mild tenderness and cramps in the abdomen
3. Blood in stool
4. Fatigue
5. Fever
6. Perianal irritation
7. Weight loss
8. Appetite
9. High risk of colon cancer

DIAGNOSIS

Since the diagnosis of UC is the same as irritable bowel syndrome, Crohn’s disease, diverticulitis and colorectal cancer i.e there should be a proper history taken. In addition to this, first of all rule out infectious causes of diarrhoea and parasite analysis should be done. Other tests that may be performed early in the diagnostic process are CBC and faecal occult blood to check for intestinal blood loss and anaemia. Uc is mostly diagnosed by sigmoidoscopy and colonoscopy.

TREATMENT OF ULCERATIVE COLITIS USING MESALAZINE

Mesalazine(mesalamine) drugs are widely used in patients with ulcerative colitis mild and moderate. It has some side effects also with its benefits. It is the first line of treatment in many patients with ulcerative colitis. It is thought to give beneficial results in controlling inflammation and it shows its effect within 2-4 weeks of initiations. Nowadays it is considered to be one of the most prescribed drugs treating more than 88% of patients. Mesalazine increased the expression of peroxisome proliferator which activates receptors in gastrointestinal epithelial cells that’s how it will be helpful in anti-inflammatory action. Also, this inhibits COX enzymes thus affecting prostaglandins and decreasing inflammation of the colon.

SIDE EFFECTS

1. Headache
2. Abdominal pain
3. Diarrhoea
4. Nausea
5. Rectal disorder
6. Bronchitis
7. Several adverse effects of this drug are reported, some of them are symptomatic such as pancreatitis, and others may be largely asymptomatic until very late-stage such as renal toxicity.

AYURVEDIC VIEW OF ULCERATIVE COLITIS

In Ayurveda, this condition can be correlated with Raktaatisara because symptoms resemble. According to Ayurveda, this disease occurs due to the impairment of Jatharagni. Vikriti of Agni has three different types:  Mandagni (hypo functioning of digestive fire), Visamagni (Irregular functioning of digestive fire), Tikshaagni (Hyper functioning of digestive fire). In Rakta Atisara mandagni is known to be the main cause. According to Acharya Charaka  Excessive intake of sour, salty, pungent, alkaline hot and irritant things and also exposure to the scorching sun, fire and hot wind causes Pittasara. If a pittasara patient is taking pitta vitiating food it will lead to Rakta Atisara.

SAMPRAPTI (PATHOGENESIS)

Due to excessive intake of causative factors → Vitiation of Pitta  →Mandagni due to its fluid properties

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Pitaatisar ←Stool break due to its laxative properties ← Purishvaha nad Udakvaha sroto Dushti

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Intake of Pitta vitiating food and drinks→ Rakta dhatu gets imbalance⇉  Rakta Atisara

MANAGEMENT OF ULCERATIVE COLITIS

As discussed above mandagni is the root cause of this disease. In the treatment of any kind of atisara(diarrhoea) in Ayurveda signs of pakva(digested) and ama(undigested) should be recognised first. Agnidiapana (enhances digestive fire), Ama pachan(digestion of undigested part), Stambhana( stops bleeding), Dhatu poshaka (nutrition supplement in the tissue level) should be given to patients according to their condition.

In the case of amavastha grahi drug should not be given because it will not be beneficial in this langhan and deepan drugs have better results. In pakvaawstha grahi drugs can be used.

Some ayurvedic practitioners prescribe drugs in Raktaatisara

1. Churna(Powder)-  Shalamali (Bombax ceiba), Shunti (Zingiber officinale), Shallaki(Boswellia serrata), Yashtimadhu (Glycyrrhiza glabra),  Dadim(Punica granatum) etc
2. Kwatha (decoction)- Kutajadi kashayam (Holarrhena antidysenterica), Dadimadi kwath etc(Punica granatum)

These herbal formulations and medicines show effective benefits in the patient of Rakta Atisara.

HERBAL REMEDIES BY PLANET AYURVEDA FOR ULCERATIVE COLITIS

Planet Ayurveda provides herbal medications which are very useful in treating diseases. These medicines are GMP certified and made up of natural products. These do not contain any preservatives, flavours or any kind of harmful ingredients. These products have magnificent therapeutic properties because of this many patients with chronic diseases are managed correctly. They have herbs and formulations for the treatment of ulcerative colitis that is discussed below.

ULCERATIVE COLITIS CARE PACK

(it is the combination of Arjuna capsules, Vatsakadi churna, Pitta balance, Kutajghan vati)

1. ARJUNA CAPSULES

Arjuna (Terminalia Arjuna) is one of the best cardiac tonic and also has other benefits like anti-inflammatory, stopping bleeding (stambhak), helping in removing tiredness (shramhara) and useful to relieve ulcers and wounds. In ulcerative colitis, it is used extensively and has given outstanding results.</9>

Dosage: 2 capsules twice daily with plain water

2. VATSAKADI CHURNA

Its main ingredients are Kutaj (Holarrhena antidyssentrica) and Bilav (Aegle marmelos). It balances tridoshas due to this it can be used in various diseases like dysentery, diarrhoea, ulcerative colitis and intestinal bleeding disorders.

Dosage: 1 tsp with plain water twice daily

3. PITTA BALANCE

It is a poly herbal formulation made up of Jahar mohra pishti(Natural Calcium  Compound), Kaharava pishti (Natural Calcium  Compound), Akik pishti, Mukta pishti (Natural Calcium Compound from pearls), Giloy satva (Tinospora Cordifolia). It balances the pitta doshas which is the main cause of Rakta atisara as explained above. Vitiation of pitta dosha is removed through the chemical components present in these capsules

Dosage: 1 capsule twice daily with plain water after a meal.

4. KUTAJGHAN VATI

Kutaj (Holarrhena antidysenterica) is helpful in controlling the symptoms of gastrointestinal disorders like loose motions are well resolved using this and many scientists prove that. It also has very good results in amoebiasis because it contains alkaloid contents. These alkaloid contents are present in kutaj with no side effects to the patient but in modern medicine which have alkaloid contents, severe drug reaction is reported.

Dosage: 2 tablets twice daily with plain water after a meal.

CONCLUSION

Ulcerative colitis is a disease which can not be cured properly but it can be managed well with the use of Ayurvedic treatment because it provides better quality of life for the patient. Various herbal medicine and panchkarma therapies have been effective in treating this disease. Ayurvedic practitioners who have profound knowledge can treat the patient well and give the patient the best treatment than any other path.