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How can ulcerative colitis affect your cholesterol? What there is to know

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June 29, 2023 – What should we ulcerative colitis do patients know about cholesterol management?

It is estimated that 200 out of 100,000 Americans have ulcerative colitis or UC. And this is a figure that has doubled in the last 2 decades. The CPU is a inflammatory bowel disease (IBD). The condition occurs in the innermost lining of the colon and rectum, causing sores inside your digestive tract. UC can alternate between flare-ups and periods of remission.

Patients with UC not only have to deal with treatment and management of digestive issues related to their IBD, but they are also at higher risk for cardiovascular disease. This risk exists even though UC patients tend to have lower cholesterol levels than those thought to be “traditionally” at risk for heart attacks and strokes.

A new study Researchers from the Netherlands have found that the cardiovascular risk factors of patients with IBD may be underestimated due to the absence of factors such as hypercholesterolemia.

“Patients with IBD have lower levels of total cholesterol, HDL-c and LDL-c, compared to the general population,” said the study co-author. Jasmijn Sleutjes, MD, researcher at the Department of Gastroenterology and Hepatology at Erasmus University Medical Center Rotterdam. “This observation is most clearly seen in patients with active disease. This is called the “lipid paradox” – the inverse correlation between lipid levels and inflammatory markers. »

A recent multi-university study found that patients with UC also face an increased risk of heart failure, although the reason is still unclear.

The lipid paradox could be a possible reason,” said the study’s co-author. Chayakrit Krittanawong, MDcardiologist practicing in New York.

“We need more data on this, especially from prospective clinical trials,” he said.

The drop in cholesterol levels is not directly caused by UC itself. On the contrary, the reason why people with UC often do not have high cholesterol has to do with how debilitating the condition can be.

“Patients with active ulcerative colitis may lose weight by limiting their food intake due to their bowel symptoms, which in turn may lead to lower cholesterol levels,” says David T. Rubin, MDProfessor of Medicine at the University of Chicago and Chairman of the National Scientific Advisory Board of the Crohn’s & Colitis Foundation.

For UC patients, it is important to manage inflammatory bowel disease while keeping cholesterol levels within a healthy range.

What are the symptoms of ulcerative colitis?

According to Crohn’s and Colitis Foundationsigns of CU may include:

  • Urgent need to have a bowel movement
  • Loose stools
  • Bloody stools
  • stomach cramps or abdominal pain
  • Chronic diarrhea

The severity of UC symptoms can vary from person to person. Some people have only mild problems, while for others UC can have a serious impact on quality of life.

What are the symptoms of heart disease and stroke?

THE CDC says Symptoms of heart disease vary depending on the specific condition.

Symptoms of a heart attack include pain or discomfort in the chest, upper back, or neck, as well as nausea, vomiting, severe fatigue, dizziness, or shortness of breath. Heart failure signs include shortness of breath, extreme tiredness, or swelling of the legs, feet, ankles, stomach, or neck veins.

Signs of a stroke come abruptly, says the CDC. They include numbness or weakness of the face, arm, or leg, especially on one side of the body; confusion; difficulty speaking; vision problems in one or both eyes; difficulty walking or loss of balance or coordination; and a bad headache.

If you have any of these symptoms seek medical attention immediately

Why are UC patients at higher risk for cardiovascular disease?

New research from the University of California, Riverside, found that patients with IBD may have fewer antimicrobial cells that protect the body against E.coli bacteria. A form of E.coli called adherent-invasive (AIEC) can then increase IBD and worsen inflammation.

Research previously pointed out that during flare-ups, patients with IBD are three times more likely to form blood clots that can lead to heart attack or stroke. This is thought to be due to increased inflammation in the body while IBD symptoms are present.

“The increased risk of cardiovascular disease in IBD is most likely related to a patient’s chronic inflammatory burden, which also plays a role in the progressive development of atherosclerosis,” Sleutjes said.

What treatment options can help with UC and how do they affect cholesterol?

Interestingly, although UC patients tend to have lower cholesterol levels, statin therapy – drugs used to treat high cholesterol – have shown promise in to prevent CPU. And a Stanford University study found that statins taken by UC patients can also reduce their risk of needing colon surgery by up to 50%. Patients with UC may also see fewer symptoms using statins because the drugs reduce gene activity patterns in UC itself.

Two other drugs, tofacitinib and upadacitinib, can also help treat moderate to severe UC. These drugs can actually raise a patient’s cholesterol level. (It should be noted that two of the newer therapies for the treatment of moderate to severe UC affect cholesterol levels.)

“Cholesterol in about 20 [to] 30% of people will go up about 10%,” Rubin explained. “However, this can be transient. HDL – ‘good cholesterol’ – and LDL – ‘bad cholesterol’ – increase at the same time. We don’t usually treat this change in cholesterol.”

People who have UC symptoms or a diagnosis should consult their doctor to find the right treatment option. In addition, it is important to have regular cholesterol checks, due to fluctuations that therapy can cause.

“There are no specific guidelines for the management of ulcerative colitis that recommend checking cholesterol, but the US Preventive Services Task Force recommends that adults know their cholesterol, given its known association with the disease. atherosclerosis,” Rubin said.

Focus on your diet with your doctor to reduce UC symptoms, monitor your nutrition, and make sure your cholesterol levels stay within a healthy range. The Crohn’s and Colitis Foundation has to guide to help you get started. You can stay in control of your health and feel better.

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