Treat The Care . . . (of Colitis)
“Well, now all this is very fine,” I hear you say, “but let’s get down to cases!” So let’s discuss what is really on your mind, namely the subject of what’s good to treat colitis. By this, of course, we mean what is good for you and not for the colitis.
MEDICINES TO BE USED
It goes without saying that the use of any medicine carries responsibility with its use. It is for this reason that the State demands certain scientific qualifications in those licensed to practice medicine. Keep this well in mind when you are tempted to try some of the new wonder drugs or some “good old-fashioned remedy.”
Bear in mind also that there is no one medicine which is equally effective in all cases. If such had been the case, don’t you realize that many centuries ago every disease would have been given a number and every remedy a corresponding number, and by now it would be simplicity itself to take the appropriate remedy. The fact is that cases differ, individual requirements differ, and individual reactions to drugs differ. That is why I urge you to take no medicine without competent guidance.
While the foregoing applies to well established cases of colitis, yet it is possible for a person who is troubled with the first phases of catarrhal colitis due to, shall we say, food irritation to take certain simple remedies with a fair degree of success. Certainly the time established use of kaolin, which is nothing but purified clay, is as safe a procedure as one may imagine. Of late years, it has been found wise to combine this with a substance called pectin which is a valuable substance derived from fruits. This latter substance has been found to have a very healing effect in cases of mild inflammation. Such remedies are available at any drugstore.
The use of a cornstarch enema is another measure that can be classified as a justifiable home remedy. It will do much to soothe the irritated bowel and, if given properly, carries with it no dangers. Its sole object is to place a demulcent coating of starch over the entire lining of the colon and thus protect it from further irritation. It is prepared in the following manner:
To a glass of cold water, a tablespoonful of ordinary corn-starch, such as that used in cooking, is stirred. Then this glassful of starch mixture is poured into a quart of boiling water, stirring while pouring. The quart of water is then allowed to cool to approximately 100° temperature and is then slowly instilled into the rectum in the following manner:
The patient is to lie on the left side with his right knee high and the left leg straight down. An ordinary enema bag holds the solution. The person administering the solution holds the bag about a foot higher than the hip of the patient. In this manner the solution will flow in very slowly. If the patient complains of cramps, the bag may be lowered to the patient’s hip, held there a few moments and slowly raised again.
When the patient feels that he has all the solution he can hold, administration is stopped and the patient is instructed to lie in this position preferably for the remainder of the night or at least as long as he can. In other words, this kind of an enema is to be retained and not expelled.
If, however, it should be expelled rather promptly, do not feel that the effort has been entirely wasted. A sufficient amount of the solution will adhere to the walls of the colon to have some beneficial effect. The next time it is administered a good deal more will be retained.
The procedure described above is not an irrigation. It is what is known as a retention enema. If properly given it is the safest of all procedures. It is much to be preferred to the colon irrigation— as will be shown a little later in this chapter.
But What About the Wonder Drugs?
Some ten years ago the so-called sulfa drugs acquired popular usage. Their power to control infections is truly nothing short of miraculous. Invalids who in former days might well have been considered doomed now get well overnight and bloom with vitality. Some of the cures effected are spectacular enough to startle even the staid medical profession. Little wonder then the public carries to excess the enthusiasm naturally arising from the discovery of such a Godsend!
Many years ago, a man far wiser than most of his fellow men contrived a bit of verse which ran something like this:
“Be not the first by whom the new are tried, Nor yet the last to lay the old aside.”
He might well have had in mind the remedies which can be known as the wonder drugs. As their use swept the country, it was found that, while they had a miraculous power of controlling some infections, they were decidedly useless in others. Thus the wonder drug lost claim to the title of “a cure-all.” Experience has proven that they have great value in selected cases.
Continued experience, however, proves still further that these drugs were not unmixed blessings. In the early days of the sulfa drug some people were killed by the very remedy that was supposed to save them. In some instances, crystals of the drug formed in the kidney and led to untold suffering and finally death.
I am relating these things not to detract from the truly marvelous powers of these drugs but to point out how dangerous it is to attempt to use them without competent medical guidance. Some people are definitely hypersensitive (some say allergic) to these drugs and their taking them only invites serious trouble. So bear these things in mind if and when you are tempted to “try sulfa.” It is heartening, however, to know that the wizards of pharmaceutical chemistry are making these drugs less and less toxic and more effective against germs. However, they all require careful handling. So play canasta or midget golf but don’t try playing doctor, at least not with the sulfa drugs.
How About the Antibiotics?
All that has been said with regard to the sulfa drugs might be repeated about antibiotics. They, too, are wonder drugs; but they, too, have left a trail of wounded and dying.
Penicillin for instance, certainly a God-given drug if ever there was one, can definitely cause poison. Aureomycin, probably one of the greatest anti-biotics, in some cases causes terrific irritation of the gastro-intestinal tract, particularly the colon. Even terro-mycin, the newest and most versatile of the anti-biotics, can cause disturbances of the lower bowel.
It behooves you, therefore, not to be carried away by any gossip about how so and so cured his colitis with a few tablets of aureomycin, chloromycetin or any other of the anti-biotics. These drugs definitely have a place in the treatment of infections, yes even intestinal infection; but they are sharp swords that should be wielded only by one who knows how. Certainly here is where a specialist can function to the best advantage for the patient and his friend, the family doctor. It is he who knows, by virtue of superior experience, exactly what these new drugs can and cannot do in his particular field.
Are Hormone Drugs the Answer To Treat Colitis?
King Solomon might have been a very wise man in his day but I’d like to call attention to the fact that his sun set many years ago. When he said, “There is nothing new under the sun,” he certainly should have excluded the field of drugs. Following in the train of sulfa drugs and the antibiotics there now comes the new group of hormone derivatives. The chief of these is cortisone. There are, of course, others in this group such as ACTH.
The astounding results obtained from the use of these drugs in certain diseases has led people, even doctors, to wonder if they might not be effective in cases of colitis. Here again, however, the element of judgment enters. In properly selected cases, where there is definite evidence of glandular insufficiency, cortisone supplies that need and helps the body, including the colon, to regain normal function.
However, even so beneficient a substance as cortisone has within it the seeds of trouble. Since its use must be continued, at least in the case of colitis, over a long period of time, its possible side effects should be known. The drug has a disturbing faculty of stimulating the growth of hair, particularly on the face. The harvest of the indiscreet use of cortisone among female patients might well be a congregation of bearded ladies. There are other side effects which can hardly be classified as desirable.
For one thing, cortisone disturbs the ability of the body to handle various food substances such as fat, protein and sugar. It also has a profound influence on the ability of the body to use minerals. When cortisone is taken in large doses over a long period of time the spine tends to lose its minerals and become bent. The face becomes round and fat and in some cases the mind is affected. Cortisone is also capable of producing diabetes in some people.
Despite the foregoing, cortisone is a remarkable drug, but like all other powerful things, it must be used judiciously. You, as a layman, cannot hope to make intelligent use of it when scientifically trained medical men are still making scientific guesses with their fingers crossed. When the doctor uses it, he is alert to its possibilities and will make every effort to safeguard you. When you take it without guidance, you might very well get the bad results first and then have little chance to wonder what next to do about it.
Treat Colitis With Anti-Histaminics?
Wonders never cease. At least not in the art of medicine. While the sulfa drugs and the various drugs produced from mold have been startling, the imagination is literally stunned by the prompt and authoritative way in which the anti-histaminics work in some cases. The wonder is still greater since we do not thoroughly understand how these anti-histaminic substances actually work.
While we do have a fairly good idea of the chemical mechanics of the sulfa drug and, to some extent, of the anti-biotics like penicillin, the anti-histaminics savor more of magic than of medicine.
It is well to bear in mind, however, that these anti-histaminic substances, like any other remedy, are but a key to a lock. While they will promptly open the lock for which they are fitted, they are of no use in one for which they are not fitted. Thus, in that very small percentage of cases of colitis which are caused by food allergy, the anti-histaminics are prompt and efficient in their control of the situation.
However, in other varieties of colitis, they have no favorable effect. Indeed, the use of anti-histaminics, since they are powerful drugs, carries with it a certain risk of bad side effects in every case. When this risk is not counterbalanced by a reasonable hope of benefit, there is not much sense in their employment. Here are some of the bad effects of anti-histaminics:
Drowsiness and dizziness are prone to occur and vision may be definitely disturbed. In some cases, headache and faintness are evident, and occasionally we see a case where vomiting and diarrhea follow the use of these substances. While these side effects are not uncommon, they are on the other hand not serious since they usually disappear upon withdrawal of the drug. One caution that should be observed, however, is that a person taking these drugs should not drive a car as his vision and his reflexes may not be equal to the task.
Consequently, it is highly unwise for a person not a doctor to try to use them since even doctors themselves are not sure of possible side effects. Do not be enticed by some good friend who says he knows a fellow who had colitis too and was cured by just three or four doses of this or that anti-histaminic. He may mean well but remember you get no refund on a parachute that does not open, nor any second chance when a powerful drug backfires.
ARE IRRIGATIONS ANY GOOD TO TREAT COLITIS?
The idea of irrigating the lower bowel in order to rid it of noxious substances and bathe it with healing ones is not by any means a modern contrivance. Anyone familiar with the history of medical treatments will tell you that, from time to time throughout the last few hundred years, the irrigation craze has taken hold, flourished for a while and then gone back to its cocoon.
At the present the idea is in the cocoon stage, though there are still sufficient numbers of irrigation advocates to warrant a few words on the subject. Perhaps it might be well to explain exactly what is meant by irrigation.
Through a double tube which is inserted into the cavity of the colon, a stream of solution is allowed to flow in to the bowel until it completely fills the colon. Through the second of the tubes, the solution is simultaneously withdrawn. Thus the solution is continually renewed and the bowel flushed out.
Theoretically, the process is as simple as washing one’s mouth. Actually there are possibilities of considerable harm. If the pressure under which the irrigation is administered is too great, the bowel can be seriously damaged from over-distention. Indeed, perforation itself may occur in a diseased bowel. Where diverticula (pockets) are present, this danger is very real. The possible good from the irrigation, in my opinion, does not counterbalance the risks.
Unless the temperature of the solution be correct, there is danger of thermal shock not only to the tissues of the colon but to neighboring organs. Finally, if chemicals which in themselves are irritant are employed in the solution, we add a chemical injury to the already damaged lining of the colon. This is the greatest danger attendant upon the use of irrigation.
It is a prevailing custom to use sodium bicarbonate in the irrigation. This in itself is definitely irritating. Naturally it evokes a response on the part of the lining of the colon. That response is a tremendous secretion of mucus. The reason why the mucus secretion poured out in so great a quantity is that it is a means of diluting and washing away the irritating bicarbonate. Yet how many times have I heard nurses and even doctors call the attention of the patient to this abundant mucus, saying: “See how it brings all that mucus out?” What they should say is, “See how much mucus this bicarbonate is causing!”
Anyone recommending irrigations of this kind is most certainly either a knave or a fool. In either event, he is not fit for the trust the patient reposes in him since he is harming him by the very treatment which he pretends will help him.
Others use a saline solution which, if it be of the proper concentration, is not irritating or harmful from a chemical point of view. However, it carries with it another danger. Where there is any kidney irritation, the absorption of excessive amounts of salt may be harmful.
My own opinion is that plain water at a temperature of 100° administered under low pressure can accomplish anything that the medicated solutions are supposed to. And the ordinary cornstarch enema of earlier in this chapter, if faithfully given, is capable of just as much good as any irrigation.
Before leaving the matter of irrigations, I should like to add a word of warning with regard to courses of treatment. In some places where irrigations are given, the patient is urged to sign up for a course of ten or some other number of treatments, usually at a discount if the entire course is taken.
From a scientific standpoint, this is, of course, unacceptable. If he needs but one and takes ten, he may actually do himself harm or become the victim of an irrigation habit which can be just as troublesome as the cathartic habit.
Before embarking on any set ot irrigation treatments, you’d do well to talk over with your friend, the family physician, your intentions. Get him to specify how many are to be taken, what solution is to be used and at what temperature the solution should be administered. By so doing, you may well spare yourself not only unnecessary expense but also injury and regrets. Written By: J. F. Montague, M.D., Continue Reading: . . . And Feeding . . . (of Colitis)