Editing Ulcerative colitis (section)

====Anticholinergics====
[[Anticholinergic]] drugs, more specifically [[muscarinic antagonist]]s, are sometimes used to treat abdominal cramps in connection with ulcerative colitis through their calming effect on colonic [[peristalsis]] (reducing both amplitude and frequency) and [[Muscle tone|intestinal tone]].<ref name="Can Med Assoc J p. ">{{cite journal | title=Drugs for Ulcerative Colitis | journal=Canadian Medical Association Journal | date=1964 | publisher=Can Med Assoc J | volume=91 | issue=21 | issn=0008-4409 | pmid=14229762 | author1=O'SULLIVAN PM | pages=1123–1124 | pmc=1928363 }}</ref><ref name="Camilleri Szarka 2008 pp. 1108–1156">{{cite book | last1=Camilleri | first1=Michael | last2=Szarka | first2=Lawrence | title=Textbook of Gastroenterology | chapter=Dysmotility of the Small Intestine and Colon | publisher=Wiley | date=14 November 2008 | isbn=978-1-4051-6911-0 | doi=10.1002/9781444303254.ch47 | pages=1108–1156| s2cid=83791469 }}</ref> Some medical authorities suggest over-the-counter anticholinergic drugs as potential helpful treatments for abdominal cramping in mild ulcerative colitis.<ref name="Amanda Fernandez, OMS IV Ronald Januchowski, DO, FACOFP 2020 pp. 10–16">{{cite journal | author=Amanda Fernandez, OMS IV | author2=Ronald Januchowski, DO, FACOFP | title=Osteopathic Primary Care Treatment Options for Ulcerative Colitis | journal=Osteopathic Family Physician | volume=12 | issue=3 | date=30 April 2020 | issn=1877-573X | doi=10.33181/12031 | pages=10–16| s2cid=219029672 }}</ref> However, their use is contraindicated especially in moderate to severe disease states because of the potential for anticholinergic treatment to induce [[toxic megacolon]] in patients with colonic inflammation.<ref name="Sedano Quera Simian Yarur 2019 pp. 943–955">{{cite journal | last1=Sedano | first1=Rocío | last2=Quera | first2=Rodrigo | last3=Simian | first3=Daniela | last4=Yarur | first4=Andres J. | title=An approach to acute severe ulcerative colitis | journal=Expert Review of Gastroenterology & Hepatology | publisher=Informa UK Limited | volume=13 | issue=10 | date=3 October 2019 | issn=1747-4124 | doi=10.1080/17474124.2019.1681974 | pages=943–955| pmid=31648574 | s2cid=204891274 }}</ref> Toxic megacolon is a state in which the colon is abnormally distended, and may in severe or untreated cases lead to colonic [[perforation]], sepsis, and death.<ref name="Desai Elnaggar Hanfy Doshi 2020 pp. 203–210">{{cite journal | last1=Desai | first1=Jiten | last2=Elnaggar | first2=Mohamed | last3=Hanfy | first3=Ahmed A. | last4=Doshi | first4=Rajkumar | title=Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions | journal=Clinical and Experimental Gastroenterology | volume=13 | date=19 May 2020 | pmid=32547151 | pmc=7245441 | doi=10.2147/CEG.S200760 | pages=203–210 | doi-access=free }}</ref>