Compounding for Crohn’s Disease & Ulcerative Colitis
An overview of Crohn’s Disease & Ulcerative Colitis (Inflammatory Bowel Disease) causes, symptoms, and treatment using compounded medication.
Crohn’s Disease and Ulcerative Colitis (UC) fall under a condition called Inflammatory Bowel Disease (IBD) and are characterized by chronic inflammation in the gastrointestinal (GI) tract.
It is estimated that 30% of patients with inflammatory bowel disease (IBD) do not respond well to current therapy or they relapse over time. New treatment options are necessary and Low Dose Naltrexone (LDN) may help these patients.
The disease is often debilitating. A GOOD compounding pharmacy is another resource for you to consider using in your journey. T&C Compounding Pharmacy are the experts in problem solving to help patients feel better.
Do you have Crohn’s Disease or Ulcerative Colitis (Inflammatory Bowel Disease)? So did U.S. Presidents (JFK!), well-known actors, musicians, comedians, and well-recognized professional athletes.
What is Crohn’s Disease?
Crohn’s disease causes inflammation of the digestive tract (mouth, esophagus, stomach, small intestine, large intestine, anus) and symptoms caused by that may be severe diarrhea, abdominal pain, and fatigue. Different areas of the GI tract can be affected in different people.
In some people with Crohn’s disease, it only affects the colon. In others it may also affect the small intestine only.
The most common areas affected by Crohn’s disease are the end of small intestine plus the colon. The symptoms of Crohn’s disease can flare up suddenly without warning and there are also times when patients do not have any symptoms.
Flare-ups of the disease can include any of the below (according to the Mayo Clinic)
- Diarrhea
- Fever
- Fatigue
- Abdominal pain and cramping
- Blood in the stool
- Mouth sores
- Reduced appetite and weight loss
- Pain or drainage near or around the anus due to inflammation from a tunnel into the skin (fistula)
Video Resource: Crohn's 101
Overview This introductory video provides information on potential causes, symptoms, treatment and overall management of Crohn’s disease. Watch on YouTube >>
Source: Crohns Colitis Foundation
Causes
Researchers think Crohn’s is likely caused by your genetics, your immune system and the environment.
Your immune system usually protects you, but with Crohn’s Disease, something causes it to launch an attack in the GI tract that won’t shut off. The inflammation goes on and on. As the lining becomes inflamed, it affects ability to absorb water and process nutrients. This leads to diarrhea and loss of nutrition.
LDN & Crohn’s Disease
Article:
Low-Dose Naltrexone Therapy Improves Active Crohn’s Disease.
The American Journal of Gastroenterology
Read Article
In this pilot study, it was hypothesized that LDN would improve Crohn’s disease by showing an improvement in blood inflammatory markers (C-reactive protein and ESR) and by showing a decline in the Crohn’s disease activity index (CDAI) scores and improve quality of life.
Article:
The Effect of Low-Dose Naltrexone on Medication in Inflammatory Bowel Disease: A Quasi Experimental Before-and-After Prescription Database Study
Journal of Crohn’s and Colitis
Source: Journal of Crohn’s & Colitis
“In an open-label study, 17 patients were given 4.5 mg naltrexone daily for 12 weeks, 67% experienced remission. There were improvements in the Crohn’s disease activity index [CDAI], quality of life, C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR].
In a double-blind placebo-controlled trial of 40 patients with active CD, there was a higher response rate among patients receiving LDN compared with the placebo. both in terms of remission defined by CDAI [88% vs 40%], by endoscopic response [78% vs 28%], and by histologic assessment of inflammation.
In a pilot study designed to evaluate safety and tolerability of LDN in 14 pediatric patients with Crohn’s Disease, several patients with treatment-resistant IBD who responded on LDN have also been discovered.
Finally, an important observations was that patients who started LDN therapy experienced clinical improvement, and that the need for other medication was decreased”
What is Ulcerative Colitis?
Ulcerative colitis affects the innermost lining of the large intestine (colon) and the rectum. It is characterized by chronic inflammation and sores. The symptoms are similar to that of Crohn’s disease. One possible cause is a malfunction of the immune system. In the past, diet and stress were often blamed for the condition but now it is known that these aggravate the condition but do not cause it. Ulcerative Colitis symptoms can vary, depending on the severity of inflammation and where it occurs.
Signs & Symptoms
According to the Mayo Clinic, some signs and symptoms may include:
- Diarrhea, often with blood or pus
- Abdominal pain and cramping
- Rectal pain
- Rectal bleeding — passing small amount of blood with stool
- Urgency to defecate
- Inability to defecate despite urgency
- Weight loss
- Fatigue
- Fever
- In children, failure to grow
Most people with ulcerative colitis have mild to moderate symptoms. The course of ulcerative colitis may vary, with some people having long periods of remission.
How Can Compounding Pharmacies Help?
Our previous blogs and much of our website focuses on Low Dose Naltrexone (LDN) for inflammatory conditions or painful conditions, although there are various ways that compounding pharmacies can help patients with either Crohn’s Disease or Ulcerative colitis (UC).
LDN is an opioid antagonist. It has a high affinity for mu receptors in the GI tract. Using LDN produces a short-term blockade of the opioid receptors which increases the amount of endogenous opioid production. The increased number of opioids in the GI tract can lead to reduced inflammation, plus healing and repair of tissues. Naltrexone also blocks TNF-alpha synthesis which can decrease inflammation.
Source: Low-Dose Naltrexone Therapy Improves Active Ulcerative Colitis
There are many ways in which compounding pharmacies can help with the symptoms of Inflammatory Bowel Disease.
Compounding pharmacies can compound rectal preparations for pain, diarrhea, anal fissure, spasms and other things into an adhesive gel that can be used rectally.
Mucolox is a compounding vehicle that we use that helps drug particles adhere to the surface of mucous membranes. MucoLox, in addition to improving and extending contact time of APIs to the mucosal surface, contains sodium hyaluronate to help hydrate the epithelial lining and improve healing.
Read about how we also use this compounding vehicle for vaginal conditions and hormones. Read More
Commonly requested formula for patients with Anal/Rectal Spasms
- Baclofen /Guaifenesin /Cyclobenzaprine HCl Suppository
Commonly requested formulas for patients with Adult Diaper Rash (due to diarrhea)
- Cholestyramine Diaper Rash Ointment
Commonly requested formulas for patients with IBS, Ulcerative Colitis, Crohn’s Disease or Proctitis:
- Mesalamine /Budesonide Retention Enema (MucoLox™)
- Sodium Acetate /Sodium Propionate /Sodium Butyrate Enema
- Sodium Butyrate Enema (MucoLox™)
- Tacrolimus Rectal Enema (MucoLox™)
- Tacrolimus Rectal Gel (MucoLox™/VersaBase®)
Commonly requested formulas for patients with Irritable Bowel Syndrome (IBS):
- Budesonide Retention Enema (MucoLox™)
- Mesalamine /Sodium Butyrate Retention Enema (MucoLox™)
- Dicyclomine / Hyoscyamine Sulfate Oral Drops
- Loperamide HCl Rectal Gel (MucoLox™/VersaBase®)
At Town & Country Compounding we do our best to work with the patient and the practitioner to offer other options for the patients in the Northern New Jersey & NYC areas.
