usually in combination with ribavirin. Hepatitis C
may also require a liver transplant.
Non-alcoholic fatty liver disease NAFLD. No single
truly effective treatment has yet been found. If obese or
overweight, patients are encouraged to loose weight
and to follow a balanced diet. Increasing physical activ-
ity and avoiding alcohol is also recommended.
Pancreatitis. If no complications occur, pancreatitis
usually improves on its own. Treatment seeks to sup-
port body functions and prevent complications with
hospitalization usually required to replace body fluids
intravenously.
Primary biliary cirrhosis. No treatment has been
shown to be beneficial in slowing the progression of
PBC. Patients are usually prescribed vitamins and
calcium to help prevent loss of bone (osteoporosis),
a common complication.
Primary sclerosing cholangitis. There is no cure for
PSC, but effective treatment is available for symp-
toms, such as the itching resulting from too much bile
in the bloodstream, which can be controlled with
drugs such as Questran or Actigall. Swelling of the
abdomen and feet, due to fluid retention, can be
treated with diuretics. In some cases, surgical proce-
dures may be used to open major blockages in bile
ducts. In the most severe cases, a liver transplant is
performed.
Infectious diarrhea. In healthy people, usual practice
is to let the illness take its course, which can last from
a few days to a week. Drinking plenty of liquids is
required and medications such as Pedialyte, Cera-
lyte, and Infalyte can be provided to replace electro-
lyte losses. Treatment with antibiotics is increasingly
complicated by the bacteria having developed drug
resistance.
Celiac disease. The only treatment for celiac disease
is a gluten-free diet.
Crohn’s disease. There is no cure available, and the
goal of treatment is to control inflammation in the
intestine and reduce the symptoms of pain, diarrhea,
and bleeding. Medications prescribed to reduce inflam-
mation include Azulfidine (sulfasalazine), mesalamine
or 5-ASA agents such as Rowasa, Pentasa or Asacol.
Serious cases usually require more powerful drugs such
as prednisone, antibiotics, or drugs that weaken the
body’s immune system such as Imuran (azothioprine),
Purinethol (6-mercaptopurine, 6-MP), Methotrexate
or Remicade (Infliximab).
Lactose intolerance. Removing milk products from
the diet is the standard treatment. Lactase enzymes
can also be added to milk or taken in capsule or
chewable tablet form.Appendicitis. Surgery is performed to remove the
appendix with prescription of pain medication.
Ulcerative colitis. Treatment seeks to control acute
attacks, prevent new attacks, and promote healing of
the colon. Corticosteroids are usually prescribed to
reduce inflammation. Medications prescribed to
decrease the frequency of attacks include mesal-
amine, azathioprine and 6-mercaptopurine. In severe
cases, the colon may be removed surgically.
Diverticulosis. Besides a fiber-rich diet, treatment
depends on symptoms. When diverticulitis occurs, sim-
ple bowel rest and antibiotics are prescribed. In severe
cases, patients may requireintravenous antibiotics or
surgery to remove the affected portion of the colon.
Dysentery. Rest and drinking plenty of fluids is the
usual treatment. Hospitalization may be required for
intravenous therapy.
Giardiasis. Anti-infective medications such as met-
ronidazole (Flagyl, Protostat) or quinacrine may be
used. In pregnant women, treatment is not started
until after delivery, because the drugs can be harmful
to the fetus.
Irritable bowel syndrome. IBS has no cure and treat-
ment is based on diet changes, medication and stress
relief therapy.
Hemorrhoids. Corticosteroid creams and lidocaine
ointments are used to reduce itching, pain and swel-
ling. For severe cases, surgical removal of the hem-
orrhoids may be performed (hemorrhoidectomy).
Anal fissures. Treatment may include the application
of a hydrocortisone cream to the anal area to help
relieve irritation, oral pain-killers such as acetamino-
phen, a stool softener such as Colace or Surfak to
prevent constipation until the fissure heals, soaking
the anal area in a warm chamomile infusion for 20
minutes to prevent infection and provide soothing
relief, and avoidance of strenuous effort to pass
stool. If a fissure does not respond to conservative
treatment, surgery may be required, involving an
operation that removes the area of the fissure and
any underlying scar tissue.
Perianal abscesses. Treatment involves surgical
drainage of the abscess as antibiotics are ineffective.
A small incision is made over the area and pus is
expelled with manual pressure. The wound is packed
with iodophor gauze, removed after 24 hours, and
the patient is instructed to take Sitz baths 3–4 times a
day for some two weeks.Nutrition/Dietetic concerns
Some digestive diseases require special diets while
others only require patients to follow the rules of basicDigestive diseases