Courtesy Photo Frederick resident Keith Krause said he is finding some good results with Remicade in his fight against ulcerative colitis which carries with it symptoms such as constant diarrhea, weight loss and a lack of energy.

UC is an inflammatory bowel disease that causes chronic inflammation of the colon, and the pain and unpredictability can throw a patient's life off course.

"Everything you're eating is not being absorbed. It's going right out, right down the toilet, literally," Krause said. "It affects your life every day."

Over the next several years, Krause said he managed his condition with mesalamine, a group of drugs typically prescribed to those with mild to moderate UC. But, in 1995, he had a serious flare-up that landed him in the hospital. This was the first of two times Krause's UC sent him to the hospital; that first time, he lost 30 pounds in one week, he said.

Even when he wasn't in the hospital, Krause said the drugs he took had some unpleasant side effects.

"The (mesalamine) made my skin yellow; I had to make up a joke or excuse when people asked (about it)," he said.

He also took the steroid prednisone for a while, but said he's glad to be done with it.

"I don't like it, it makes you irritable, and you don't sleep. Hopefully, I'll never have to take it again," he said.

In 2006, Krause was introduced to Remicade, a drug that had been approved for Crohn's disease, another inflammatory bowel disease, in 1998 and for the treatment of UC in 2005.

Remicade is an anitbody that blocks tumour necrosis factor alpha, or TNF, a chemical messenger of the immune system that causes inflammation in people with UC. Once the inflammation is under control, the patient's bowel can heal, said Dr. William Sandborn, a professor of medicine and vice chairman of the division of gastroenterology at the Mayo Clinic in Minnesota.

Sandborn was the lead investigator in a study that found that Remicade reduced the need for colectomy, or surgical removal of the colon, by 41 percent. The study was published in the October issue of Gastroenterology.

About 25 percent of UC patients ultimately undergo colectomy, Sandborn said. The Remicade study is significant in that most studies measure how effective a drug is on symptoms, while Sandborn's study went a step further to measure the effectiveness in reducing the need for surgery, he said.

Krause's first two Remicade treatments were in Frederick , but his doctor then recommended he begin receiving treatments at the University of Maryland Medical Center, which has staff more specialized in Remicade treatment.

"They don't want to give it to you right away, but you become married to it, so to speak, because you always have to take it," Krause said.

Krause travels to UMMC to receive Remicade intravenously every eight weeks. The process takes between four and five hours, he said.

Though Remicade offers hope to many people dealing with moderate or severe UC, it comes with risks. Since Remicade weakens the immune system, patients are at a higher risk of contracting infections and are less able to fight off other illnesses Sandborn said. It can also raise a patient's risk of developing lymphoma, he said. But, for many patients, especially those who don't respond to other medications, the benefits outweigh the risks, Sandborn said.

Remicade "has made life a lot easier to live," Krause said.

Though he says he still has at least some pain in his stomach area every day, Krause doesn't let it affect his daily life. Now 44, he has three children and works as a financial adviser. He also runs and works out regularly, and even ran the Baltimore Marathon in 2008.

"I have UC, it doesn't have me. I don't let it affect me," he said. "Some days the pain is worse than others, but after time you get used to it, and this is what it is," he said.