Imagine having to run out of the middle of a class lecture to head to the bathroom. Imagine doing this 10 to 20 times a day.
This is the embarrassing situation faced by students who have ulcerative colitis.
Ulcerative colitis is an inflammatory disease characterized by its attack on the inner lining of the colon and the large intestines. This disease causes ulceration of the innermost lining of the colon.
Dr. Dan Pambianco, a gastroenterologist and director of Charlottesville Medical Researchis studying new dosages of Asacol, the anti-inflammatory medication currently used to treat ulcerative colitis.
The most common symptom of ulcerative colitis is diarrhea. Seventy percent of patients experience mild to severe diarrhea. Gastroenterologist Dr. Stephen J. Bickston at the University's Digestive Health Center says his patients describe consistent symptoms of bloody diarrhea, inability to pass gas, cramping and frequent trips to the bathroom for over two weeks.
Charlottesville Medical Research, which is not affiliated with the University, has been involved in studying the dosage changes of Procter & Gamble's Asacol.
Asacol has been approved by the Food and Drug Administration but only at a lower dosage. This clinical trial will see if increasing the dosage with a time-release mechanism is safe and effective for patients.
One million Americans between the ages of 15 and 25 privately suffer from inflammatory bowel disease. Of those cases, 500,000 are ulcerative colitis. Ulcerative colitis mysteriously plagues people during a person's late teens, 20s and 30s.
"It is difficult for young people because ulcerative colitis happens when appearance is so important to them," Bickston said. "I get quite a few student and faculty cases each week."
In the past, a young person would be advised to take low levels of Asacol to reduce inflammation. Normally, patients would take 18 pills a day to regulate their symptoms.
One of the advantages of using a greater dosage of Asacol instead of the normal amount is its cost efficiency. Additionally, patients would only take six pills instead of the normal 18. Patients in previous clinical trials noted less serious side effects than the normal treatment
The safety and efficiency of the drug, however, has not been tested. The clinical trial in Charlottesville will evaluate this.
The cause for ulcerative colitis remains a mystery to many doctors. Bickston said that a person can't catch it from their roommate, by living in a dorm or sharing a bathroom with someone. Researchers such as Pambianco have correlated ulcerative colitis with a patient's genetic predisposition and the environment to which he/she may be exposed.
A person may be more susceptible to developing bacterial or viral infections due to a weak immune system that ultimately leads to inflammation in the intestinal wall and the colon. Twenty percent of the patients with ulcerative colitis indicated that they had a close relative who also had this disease.
There are several other options for treatment ranging form drug therapy, dietary regimen and surgical removal of the colon. Pambianco said that doctors would remove the colon only in very severe cases when medications have not reversed the effects or when long standing incidence of colitis increase the chances of colon cancer.
Bickston described a focus group formed at the Digestive Health Center composed of patients to help them discuss the positive and negative aspects in each treatment. If a person chooses to have their colon surgically removed they have freedom form the fear of developing colon cancer in the future. A patient also would not have to deal with frequent check-ups of the colon through the colonoscopy.
But both Bickston and Pambianco stress that young people suffering from ulcerative colitis can lead a normal life if they simply watch their diet and take their medicine.
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