The initial treatment depends upon how severe your disease is and also the length of colon involved. 5-ASA Compounds & A Simple Method for the Determination of its Levels in the Lining of the Large Bowel5-Aminosalicyclic acid ( ASA ) compounds are medications that act to reduce the amount of inflammation central to some disorders of the bowel, such as Crohn’s and ulcerative colitis. In patients with ulcerative colitis, they have been shown to be very effective in inducing and maintaining remission of disease. Levels of 5-ASA in the lining of the bowels have been shown to predict efficacy and possibly act as a marker for clinical endpoints in patients with disease. A clinical trial was performed by Haines et al, to try and determine a simple, yet sensitive and reproducible method for detection of 5-ASA in the lining of the bowel. Specific concentrations of 5-ASA were added to biopsies (tissue samples) of the lining of the colon. From the study, clear, reproducible peaks were achieved at certain wavelengths. These peaks were significantly sensitive for 5-ASA. What we need to do now is to apply these results in a clinical context. Genes Implicated in IBD – IL23R is an IBD Susceptibility Gene (confirmation in an Australian cohort) and GLI1 gene a Risk Factor for Ulcerative Colitis With advances in research and from results of clinical studies, additional insight into the causes and genetics behind ulcerative colitis has been obtained. For example, variations in particular receptors such as the IL 23 receptor has recently been shown to be associated with both Crohn’s and ulcerative colitis. Another gene called the GLI1 gene plays a significant role in the formation and maintenance of a healthy lining for our gut.
Specialist to help ease wait times
September figures show priority-one gastroenterology patients waited an average 47 days to be seen at the outpatient clinic – 50 per cent longer than the recommended 30-day maximum – and category-two patients waited an average 16 weeks. But waiting times have improved since a year ago, when some children waited up to a year to be assessed because of an acute shortage of gastroenterologists. It prompted the State Government to launch an urgent recruitment drive for specialists. The hospital says progress has been made after finding a gastroenterologist to fill a vacant position but it will have to take on more staff. A spokeswoman said PMH expected waiting times to improve further with a new part-time gastroenterologist due to start this month. Another 0.5 full-time equivalent position was in the appointment process and PMH was optimistic about appointing someone early next year. The Australian Medical Association welcomed the recent addition of a specialist but said it was clear more were needed to keep up with demand in the highly specialised area. WA president Richard Choong said gastroenterology was historically a difficult specialty to staff, which led to long delays for patients to be assessed and treated. “The fact PMH has managed to find someone recently and is close to more appointments is good news and very encouraging,” he said. “This is an area of medicine that is very specific and there are many conditions that need to access its services, but it’s a classic example of where there just aren’t enough people to do the jobs required.” Dr Choong said as a result many children were waiting too long, often in pain and discomfort, to be diagnosed and treated. “What I really hope is that the hospital will be able to recruit the extra staff it needs so children can be seen even more quickly,” he said.