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 Ulcerative colitis (UC) - a very insidious disease. It is a chronic inflammation of the colon of unknown origin with the formation of erosions. Prevalence of UC ranges from 28 to 117 cases per 100 thousand population. Onset of the disease is observed between 15 and 40 years of life, the second peak of incidence observed in the age period of 50-80 years.
About ulcerative colitis
Despite the fact that the etiology of the disease is not precisely defined, in recent years, significant progress in the study of the emergence of non-specific colitis. A virus or infection causes only acute onset of the disease, and an explanation of chronic origin must be sought in something else. Low immunity, poor nutrition, use of medications (including contraceptives and nonsteroidal antiinflammatory drugs), worm infestation, impaired metabolism, lack of B vitamins and vitamin K, stress, depression, and other diseases can trigger the appearance of the disease. But smoking and appendectomy at a young age to prevent the emergence of UC.
In the course of the disease there is the development of inflammatory reactions causing a violation of intestinal barrier function, metabolic and regulatory disorder of mucus, chronic intoxication. UC refers to an autoimmune disease, that is, the body is unable to deal with the disease, unable to stop the acute inflammation of the bowel, with the result that there is a chronic colitis.
The clinical picture of UC depends on the prevalence of the disease and the severity of inflammation. The main symptoms of the disease can be divided into two groups: Local and general. Local symptoms include blood in the stool (it stands out from the rectum and large intestine), diarrhea, false urge to void, acute abdominal pain, tenesmus (painful urge to defecate). Among the common complaints is dominated by decreased performance, fatigue, weight loss.
Bloody diarrhea - the most common symptom of non-specific colitis. The blood from the intestines can be released with the feces, to be mixed with mucus and pus, or pure. With the defeat of the rectum blood is on the surface of the stool, with the defeat of the intestine divisions, which are located remotely, the blood is mixed with feces. Most patients experience frequent bowel movements, defecation frequency ranges from 4 to 10 times a day, and in severe disease - 12 - 20 times. Fever, anorexia, tachycardia, abdominal bloating, abdominal pressure are typical for the acute stage of the disease.
Very often the disease develops on the psychological level, there is concern for the condition of the person's own health and life, the patient begins to exaggerate that colitis - a fatal disease (asthenic-hypochondriac syndrome). It is also not without depression and fear of occurrence of malignancy (cancerophobia).
Treatment of ulcerative colitis
Numerous studies in recent years have shown that the basis of medical treatment is drugs of mesalazine
. Before the advent of drug mesalazine, sulfasalazine NUC treated, which under the action of bacterial enzymes in the colon is split into two components - a 5-aminosalicylic acid (5 -ASK or mesalazine) and sulfapyridine
. It is proved that sulfapyridine has no anti-inflammatory activity, thus responsible for all the side effects of sulfasalazine, the frequency of which is on average 20-25%
. The use of this medication may cause nausea, vomiting, anorexia, dyspepsia, headache
. Sometimes allergic reactions, pancreatitis, hepatotoxicity, hemolytic anemia
. Scientists have found that mesalazine (5-ASA) - the only active ingredient that helps to reduce inflammation in the gut, so developed on its basis a number of drugs
.
  
Since Yak most important site of action is the colon, the maximum drug release should occur here. Therefore, the coated tablets are special requirements. Selection of the dosage form of the drug should be based on the characteristics of the particular patient, should also take into account differences between preparations of mesalazine depending on the choice of the shell, which is responsible for its dissolution. In tablets
Asacol
("Lek", Slovenia, in cooperation with "Tilots Pharma AG", Switzerland), tablets and granules Calofalk ("Dr. Falk GmbH", Germany) and tablets
Mezavant
("Cosmo S.p.A.", Italy) Inert, pH-dependent coated providing release mesalazine throughout the colon. Asacol and Mezavant dissolve above pH 7, which causes the active effect of the drug in the desired intestine (colon pH - 8, 5 9, 0).
Salofalk
It allows release of the active substance at a pH of at least 6, (slightly smaller dose of the active substance reaches the colon than Mezavanta and Asacol). Therefore, for good digestion Salofalk tablets should be taken before meals! But Salofalk granules just have a skin that slows the release of mesalazine, to enable it to dissolve in the colon.
Thus, from the standpoint of pharmacokinetics more effective medicinal forms are Asacol mesalazine, Mezavant granules salofalk, and after they are salofalk tablets. Before the use of these drugs should consult with a physician. Also, during treatment, follow a strict diet, give up fried, spicy and sweet.
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