I was told that there are four main types of drugs used to treat severe cases of UC like mine: steroids, aminosalicylates, biological and immunosuppressants.
I had been on steroids since I was admitted to hospital, with the exception of two days in the beginning where they took me off of them temporarily. At first the doctors were extremely interested in the fact I’d been living in Turkey for six months and they thought I may have picked up a nasty stomach bug that I hadn’t got out of my system, so I was put on a mixture of steroids and antibiotics – steroids would reduce any inflammation and antibiotics would treat any infection but because of how ill I was at first, they put me on both to try to get whatever it was under control as quickly as possible. After a couple of days of being on both, my bloods had improved ever so slightly so they took me off the steroids for 48 hours. In that 48 hours my bloods went downhill again, this helped to confirm the diagnosis of IBD over a tummy bug as it was the steroids that had improved me.
However when I was diagnosed with UC, I was then put on other drugs as well that are usually used to treat it. I was given a bit of basic background information about them and what each group would do.
Steroids are used to reduce redness, swelling and pain. These help in cases of IBD as they bring down any inflammation in the body. However they can not be used in the long run as they have quite a few side effects. Short term side effects include acne, increased appetite, weight gain, insomnia, hair loss and mood swings however long-term use of steroids can cause more serious side effects such as osteoporosis and cataracts. I was put on prednisolone. The “usual” dose of prednisolone for severe flare ups is 60mg however, I was straight away put on 100mg which has been gradually lowered and increased over the last few months.
Aminosalicylates (5ASA’s) slow down the inflammatory process and allow damaged tissue to heal and usually work well with steroids in treating UC. They’re usually taken for the long term to help maintain remission after a flare up, and then if a flare up happens that’s when steroids are introduced. However, as this was my first diagnosed flare up, I was put on both to try to bring the inflammation down as quickly as possible. I was given mesalazine, in particular pentasa. I’m not sure what the usual dose for this is, but I was on 200mg twice a day, which I’m assuming is a lot because every day, morning and evening, the nurses would double-check my drug chart as they were surprised at the dose I was on. They were horrible tablets which started to dissolve as soon as they touched my tongue and were really hard to swallow, so I improvised and had them with a yoghurt because it was the only way they would stay down.
Biological drugs are used to try and reduce the inflammation in the intestine by preventing the body from producing a certain type of protein which the immune system uses to stimulate inflammation. I can’t remember the name of the biological drug I was being given, but it was intravenously I remember that much…
Immunosuppressants reduce the activity of the immune system in the body. As UC is an autoimmune disease, this means that it is the bodies immune system that has malfunctioned slightly and is actually attacking itself rather than the foreign bodies it should be fighting. Immunosuppressants are meant to stop this from happening as much. In treatment for UC, immunosuppressants are used as a last resort when steroids and 5ASA’s have failed to work and bring the inflammation under control.
By the 22nd November I was on quite a mixture of drugs. I was taking the following and my collection of tablets looked something like this… (picture isn’t actually one of mine, just one I found on Instagram of most of what I was on)
PREDNISOLONE (steroid): intravenously, 25mg, every six hours, totall 100mg a day
MESALAZINE (5ASA): orally – 2000mg, twice a day; enema – 1g / 100ml every night
PARACETAMOL (painkiller): intravenously / orally, 1000mg, 4 times a day
ORAMORPH (painkiller): 20ml or 50ml as and when needed
BUSCAPAN (muscle relaxant): 1 tablet a day / 1 injection a day
ADCAL D3 (calcium): 2 tablets, twice
CLEXANE (anti-clotting): 40ml injection, once every evening
I was also on antibiotics (one tablet, three times a week or intravenously) and magnesium and potassium, also intravenously, as my levels kept taking a nose dive on an almost daily basis.