Talk:Ulcerative colitis/Archive 4

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epidemiology

Though the statement saying UC is more common in women is cited, I can't pull up the article myself. I've read conflicting information, including that it's more common in men and, separately, that there's no difference between genders. The latter is cited in this article... UpToDate is reputable, but I have to question it, too, since it ignores bimodal distribution... But when it comes down to it, do we really know? Anyone who can speak to the epidemiology of UC (and CR), please weigh in.

http://patients.uptodate.com/topic.asp?file=digestiv/10728

rhetoric 05:19, 21 October 2007 (UTC)

Phosphatidylcholine

Rather impressive results in a small trial in steroid-refractory UC. JFW | T@lk 22:25, 1 November 2007 (UTC)

Diagnosis

Diagnosis often does not occur until after 2-3 years of significant symptoms, often assumed to be hemmoroids or Irritable Bowel Syndrome, significant facts that I didn't see mentioned in the aticle. Something else pertinent, although I'm not sure if this could be worked into the article, is that many Gastroentrologists don't accept pediatric patients because of insurnce reasons. Which makes a certain amount of sense, but was fairly ridiculous when I was a 16 and a 5'10", 140lb. pediatric patient who metabolized drugs as an adult would, and could understand procedures/explain symptoms more adequately than many adults are capable of.LeeRamsey (talk) 01:00, 27 January 2008 (UTC)

Smoking and UC

Smoking and UC is mentioned in this article but not the evidence that quitting can cause UC and resuming can stop it. See: http://members.iinet.net.au/~ray/2consequences.htmlRayJohnstone (talk) 17:23, 5 April 2008 (UTC)

Bacterial infections

Is there no data to support possible role of bacterial infections? To my knowledge there are several strains that may or (to be fair) may not play a role in UC. Any thoughts on why is this an area that is continually ignored or discounted? I'm struck by the heavy leaning towards targeting/treating symptoms and the focus on the immune system. As a user of Wikipedia I'm looking for more than just the "party line" - that UC is genetic - so that pharma companies can sell their molecules. To do this article (and more importantly patients) justice, requires a critical look at the role bacteria in UC. How can we ignore it when we've just begun to scratch the surface of what makes up our intestinal flora? —Preceding unsigned comment added by 70.71.203.66 (talk) 03:07, 28 April 2008 (UTC)

Why should accutane info not be included?

Why should accutane info not be included? 75.169.53.136 (talk) —Preceding comment was added at 23:13, 18 May 2008 (UTC)

Properly sourced it probably should. The reference you've provided however, is too promotional and you've spammed it. --Ronz (talk) 02:48, 19 May 2008 (UTC)

Its a source, just because its a commercial source doesn't mean its spam. Find a better source or leave the info unsourced. 75.169.53.136 (talk) 02:55, 19 May 2008 (UTC)

The information has been spammed to multiple articles at the same time without discussion. The reference used failed WP:SPAM and WP:RS. The new source is better, but I think it needs better sourcing per WP:NPOV. --Ronz (talk) 03:35, 19 May 2008 (UTC)
I agree with Ronz, the information does not pass multiple policies as stated in the reverts. Thanks, --CrohnieGalTalk 12:10, 19 May 2008 (UTC)
You can actually read English, right? 75.169.49.214 (talk) 19:14, 25 May 2008 (UTC)

The link is Washington Post. If you continue to delete valid information. I will report you. I changed the source. Perhaps you should actually READ before making edits. 75.169.49.214 (talk) 19:13, 25 May 2008 (UTC)

LDN

Sorry if it's not the done thing but a massive thank you to the person who added the low dose naltrexone information. I've had active UC for 4 years, never heard of LDN until I saw it on here. I've been on LDN as result of this now for a couple of months and am now in remission. Thank you so much! —Preceding unsigned comment added by 78.156.66.5 (talk) 00:58, 20 June 2008 (UTC)

Nicotine is a parasite?

It doesn't seem to make much sense to list nicotine in the parasite section? 87.115.2.184 (talk) 00:20, 13 July 2008 (UTC)

New EL added

I changed the URL to the page about UC as the home page immediately hit me with a pop up ad. This way it does not advertise up front as it did before. I hope this was ok with you for me to make the change. --CrohnieGalTalk 13:11, 14 July 2008 (UTC)

I rolled back my changes and then deleted the two discussion boards (one was a definite blog.) I tried to change the link that was newly added but I guess I have too much meds in me because I can't figure out what I am doing wrong, sorry. I was trying to change the one link to this [1] which allows the page without an immediate pop up advert hitting. I really think though that the EL should have the UC section listed in the EL instead of the home page or it will probably be deleted as it is now in the future. Sorry, I am trying but it seems not to be a good day for me. --CrohnieGalTalk 13:48, 14 July 2008 (UTC)

Replaced the following "fact" with one with a citation:

``Ulcerative colitis is a fairly common disease, with an incidence of about one person per 600 in the United States[citation needed].

Environmental factors -> Diet

"Environmental factors

Many hypotheses have been raised for environmental contributants to the pathogenesis of ulcerative colitis. They include the following:

Diet: A diet low in fermentable dietary fiber may affect ulcerative colitis incidence."

What kind of effect? Positive or negative? Or does it depend on the patient?

Kritical Hit (talk) 05:18, 24 November 2008 (UTC)thesepennies

Food trigger addition

I reverted this information as it is being spammed to a lot of articles, which also other editors deem the addition inappropriate. Diet is very individual for each patient so putting up a list like that is not encyclopedic in my opinion. Above someone asks about diet, the pros and cons etc, I think the answer I give here explains but if the editor would like more details or specifics feel free to drop by my talk page. As for the list, I reitterate, it doesn't belong in the article. --CrohnieGalTalk 20:44, 11 December 2008 (UTC)

Dietary modification

I'm not an editor here but I think the Dietary modification section of this article is pretty bad. The suggestion of brassica fiber references a study of on stomach ulcers not ulcerative colitis. The oatmeal suggestion seems to be begging for a reference. Most recommendations for dietary modifications for ulcerative colitis suggest a reduction of insoluble fiber as it can further irritate intestinal inflammation. Just google "ulcerative colitis diet" and you'll find plenty of talk about low fiber and low residue diets. I think the most responsible message would be to say that individuals must learn which foods are triggers for their ulcerative colitis and probably avoid insoluble fiber during UC flare-ups.

Of course its complicated and there are studies of psyllium husk fiber additions that appear to help ulcerative colitis. So maybe if you are going to include the fiber recommendation at least use better references:

C. Hallert‌, M. Kaldma‌, and B. G. Petersson‌, 1991. Ispaghula Husk May Relieve Gastrointestinal Symptoms in Ulcerative Colitis in Remission. Scandinavian Journal of Gastroenterology. Vol. 26, No. 7, Pages 747-750

F Fernández-Bañares MD et al. 1999. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. American Journal of Gastroenterology. 94, 427–433; doi:10.1111/j.1572-0241.1999.872_a.x —Preceding unsigned comment added by 128.101.134.237 (talk) 17:44, 22 March 2010 (UTC)


Kookery

Quote from #Dietary modification section:

Of peculiar note is fibre from brassica, which seems to contain soluble constituents capable of reversing ulcers along the entire human digestive tract before it is cooked.

Should we perhaps suggest some cooking methods or recipes for ulcer-reversed human digestive tract? Tract à l'orange, or perhaps a simple tract salad? mikaultalk 23:34, 3 March 2009 (UTC)

LDN and other positives

LDN was added by me anonymously. Our 11 year old son has consistently been better after starting using it 1 year ago. However he is also still on Asacol and Azathioprine, so it is not a scientific fact, just an overall impression.

As dietary supplements we're using Litozine (documented medical trials for reducing inflammations and pain - although a quite mild effect). No side-effects that I can find, nor interference with other medication. [2]
Further probiotic capsules from [3]
--Greylensman (talk) 18:36, 27 October 2009 (UTC)


Adacolumn in use for both UC and Crohn's - but not in USA

Adacolumn is simply put not a medicine, but a way of filtering out excessive white blood cells via apheresis. Excessive white blood cell counts are linked to inflammatory diseases. According to Otsuka Pharmaceuticals available in Austria, France, Germany, Spain, Italy, the Nordic and Baltic region, Switzerland, the UK and Japan. External link [4]
How about adding this info to the treatment section - even if not available in the USA?
Wikipedia after all has an international audience.
--Greylensman (talk) 19:14, 16 November 2010 (UTC)

Assessment

IMO, this article barely meets the B-class standards. To progress to a higher rating, it needs to more sources named, particularly high-quality sources such as medical textbooks, and some attention given to balance (such as removing treatments that are primarily supported by anecdotal evidence). WhatamIdoing (talk) 22:10, 1 January 2010 (UTC)

Well, IMO people often turn to encyclopedias while searching for new information, so room should be allowed for listing new information, which by virtue of being new has not made it into the established medical text books. Tagging or highlighting some information as uncertain or indicating a particular treatment is only tested and approved in some countries or parts of the world is quite OK. Overzealous deletion OTOH can remove much of what makes an article valuable.--Greylensman (talk) 23:52, 28 January 2010 (UTC)

Also, the section comparing the two diseases states the risk associated with smoking. It states that there is a "lower risk for smokers" to contract UC. This makes the article read like smoking reduces the chance to contract UC, which I doubt was the intended meaning. Instead this should read something like "Smokers and non-smokers face the same chance of contracting UC." 24.93.132.122 (talk) 15:50, 30 July 2010 (UTC)

Specific Carbohydrate Diet

I support the removal of material related to this diet, when it consists entirely of uncritical advocacy of a treatment that has not undergone reviewed clinical trials.

Nevertheless, there is some credible evidence that diet can have an impact on this condition. Can we examine some of the following sources and perhaps try to expand the Dietary modification section to broaden its coverage?

  • Gottschall's book is in print: Gottschall, Elaine Gloria (August 1994). Breaking the Vicious Cycle: Intestinal Health Through Diet. Kirkton Press. ISBN 978-0969276814. Retrieved 11 February 2010.
  • Reviews of the book on the SCD site: "Reviews of Elaine Gottschall's book". Specific Carbohydrate Diet. Retrieved 11 February 2010. – amongst the cruft, there's one extensive, seemingly balanced review, which is cited as published in The Canadian Journal of Gastroenterology - Volume 10 Number 2 - March/April 1996, but I can't find the article in the journal archives for 1996

Interestingly, the book review/journal article above does cite some work to support it:

  • "For example in severe ulcerative colitis there is evidence that improvement can be achieved by severely restricting all starches and sugars" – cited to: Montgomery RD, Frazer AC, Hood C, Goodhard JM, Holland MR, Schneider R. Studies of intestinal fermentation in ulcerative colitis. Gut 1968;9:521-6 (but I can't find this either).
  • "In addition, necrotizing enterocolitis, a severe type of gastroenteritis, is often observed in premature infants (in whom lactase enzyme levels have not yet reached maturity) who were fed lactose containing (whey-based) formulas" – cited to: Lifshitz F. Necrotizing enterocolitis and feedings. In: Lifshitz F, ed. Pediatric Nutrition. New York: Marcel Dekker, Inc,1982:513-30 (which doesn't show up in a Google search).
  • "The unifying hypothesis proposed is that unabsorbed carbohydrate (ie, lactose) combines with casein or other proteins to form toxic compounds" – cited to: Clark DA, Miller MJS. Intraluminal pathogenesis of necrotizing enterocolitis. J Pediatr 1990;117:564-7 (which exists and is cited a couple of times, but doesn't seem to be supported)
  • "A recent study showed that oligofructose and inulin, naturally occurring indigestible carbohydrates, promoted the growth of bifidobacteria in the human colon" – cited to: Gibson GR, Beatty ER, Wang X, Cummings JH. Selective stimulation of bifidobacteria in the human colon by oligofructose and inulin. Gastroenterology 1995;108:975-82 (which has a doi:10.1016/0016-5085(95)90192-2 and is well-cited, but I'm not sure of its relevance)

In summary, although I'm no fan of bald promotion, I could accept there was more of a link between diet and UC than the section Dietary modification currently indicates, iff someone can point to some reliable studies making the case. It's possible that following the trail of Gottschall's book (and the works that it purports support it) might be a huge crimson clupeid, or there might be something we can use. Perhaps someone more qualified than I can comment. --RexxS (talk) 14:55, 11 February 2010 (UTC)

Yes exactly Doc James (talk · contribs · email) 19:48, 11 February 2010 (UTC)

Don`t forget the book from Dr. Wolfgang Lutz "Leben ohne Brot" (means, life without bread). http://de.wikipedia.org/wiki/Lutz-Di%C3%A4t ( http://translate.google.de/translate?hl=de&sl=de&tl=en&u=http%3A%2F%2Fde.wikipedia.org%2Fwiki%2FLutz-Di%25C3%25A4t ) He started the Low-Carb wave with his studies about carbohydrate effects on chicken in 1950-60. Wolfgang Lutz claimed more than 10,000 patients during his 40-year period of his practice treated with diet and chronic diseases in order to have healed many, including Crohn's disease, ulcerative colitis, gastric disorders, gout, metabolic syndrome, epilepsy and multiple sclerosis. Both, Gottschall SCD- and Lutz-diet have positive effect on UC but no studies were made about this chances to handle UC successfully. Only the effect on Morbus Chron was reported in the Chron-V study. Search on YouTube for SCD and you will find voices regarding the effect. The diet ist known since 50 years. But no study? Why? No money to make with? Now in sweden low-carb-high-fat is the actual trend. At the beginning for diabetes type 2. But it has effect on UC also as it is basically simmilar. With best reagards from Germany NRWKalle1967 (talk) 22:51, 27 September 2010 (UTC)

Please read WP:MEDRS for information on sourcing for Wikipedia. Doc James (talk · contribs · email) 03:20, 28 September 2010 (UTC)

Casey Abrams (singer)

I'd just like to add a note that there are media reports that one of the top contestants on American Idol has this condition and has been hospitalized for it, so it wouldn't be surprising if this article got some extra attention over the coming weeks. Looie496 (talk) 17:32, 11 March 2011 (UTC)

1st hand experience - essay on salon.com

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