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Tenesmus
Abdominal pain
Anorexia
Raised temperature
Immunologically mediated
Genetic influences
Environmental influences
Tragnone et al 1995 Dietary habits as risk factors
for inflammatory bowel disease. Eur J Gastroenterol
Hepatol. Jan;7(1):47-51.
M - cells Ulcer
Phospholipase A
Macrophage CD-4
cell Free fatty acid
Activated Activated
macrophage CD-4 cell
NF - kB IL - 4 cyclooxygenase-1 2,5-lipoxygenase
TNF - alpha IL - 1 IL - 8
Th - 2 Prostaglandins Leucotrines
Adhesion molecules predominates
(ICAM-1, E-Selectin) in UC
Mast
cells
Systemic manifestations To the bowel Leading to Prostaglandins
of leading to degranulation Production of from
malaise / fever Inflammation of neutrophols cytokines cyclooxygenase-2 LTB-4
I N F L A M M A T I O N
adapted from Palmer and Penman 2000, Sands 1999, Boik 2001 and Rang et al 1999.
Patient Details First Visit Oct 07 Advice / Outcome
Treatment
Male: 34, BMI 24 Prev. azathioprine Rx 3 wks pred 15 mg
10 yr hist. Stable 150mg om stopped Chamomile 25 More relaxed, sleep
last 5 yrs platelets Tormentil 25 better, n. sweats,
Vib opulus 25 Freq loose stools,
Diet: meat, proc. Colitis returned Symph fol. 25 no blood.
Foods, wine, coffee within month. 5 ml tds 300ml -Torm +Agrimonia,
F&V, Omega-3
Rx Predsol enema calendula
didn’t work Lamberts Tumeric
Lifestyle: Self-
employ Acidophilus 10 3 Months no pred.
Stress, poor Bloody stool 6x d, Stools loose 1-
sleep Abdom. Cramps, Diet: Add fish and 2x/day
Fatigue, night cooked veg. -Agrim + Hydrastis
Medication: sweats, work Rooibosh + -FOS 1 tsp
Prednisalone 40mg limited, v. anxious Chamomile tea
om Self Rx bland diet freely 5 Months feeling
Dipentum 1g tds well
Stools normal
Rx tea ( treating
other issues)
Constituents – Curcumin one of the main
constituents
Action - anti-inflammatory action on the
enzymes 5-lipoxygenase and cycloxegenase
(Ammon et al 1993. Mechanism of antiinflammatory actions of
curcumin and boswellic acids. J Ethnopharmacol. Mar;38(2-
3):113-9.).
inhibit nuclear factor kappa B (NF-Kb) (Singh
and Aggarwal (1995 ). Activation of transcription factor NF-kappa
B is suppressed by curcumin (diferuloylmethane) J Biol Chem.
Oct 20;270(42):2 4995-5000).
Curcumin maintenance therapy for ulcerative
colitis: randomized, multicenter, double-blind,
placebo-controlled trial. (Hanai et al 2006 Clin
Gastroenterol Hepatol Dec; 4(12): 1502-6. )
Constituents
M - cells Ulcer
Phospholipase A
Macrophage CD-4
cell Free fatty acid
Activated Activated
macrophage CD-4 cell
NF - kB IL - 4 cyclooxygenase-1 2,5-lipoxygenase
TNF - alpha IL - 1 IL - 8
Th - 2 Prostaglandins Leucotrines
Adhesion molecules predominates
(ICAM-1, E-Selectin) in UC
Mast
cells
Systemic manifestations To the bowel Leading to Prostaglandins
of leading to degranulation Production of from
malaise / fever Inflammation of neutrophols cytokines cyclooxygenase-2 LTB-4
I N F L A M M A T I O N
adapted from Palmer and Penman 2000, Sands 1999, Boik 2001 and Rang et al 1999.
Number of factors associated with UC
Small number of studies that
demonstrate effectiveness of herbs
Need for more studies