A list of the specialists that you may be asked to see:

A rheumatologist (a doctor specialising in arthritis) often manages the patients overall treatment and treats joint disease. The following specialists treat other symptoms that affect different body systems:

Rheumatologist—treats joints and inflammation.
Gynaecologist—treats genital sores in women.
Urologist—treats genital sores in men.
Dermatologist—treats genital sores in men, and skin and mucous membrane problems.
Ophthalmologist—treats eye inflammation.
Gastroenterologist—treats digestive tract symptoms.
Neurologist—treats central nervous system symptoms.
Paediatrician—treats child patients.
Counsellor—

How Is Behçet's Disease Treated?

Although there is no cure for Behçet's disease, people can usually control their symptoms with medications, rest, exercise and possibly a change in lifestyle. Treatment goals are to reduce discomfort and prevent serious complications such as disability from arthritis or blindness. The type of medicine and the length of treatment depend on the person's symptoms and their severity.

It is likely that a combination of treatments will be needed to relieve specific symptoms. Patients should tell each of their doctors about all of the medicines they are taking so that the doctors can co-ordinate treatment.

Topical Medicine

Topical medicine is applied directly on the sores to relieve pain and discomfort. For example, doctors prescribe rinses to treat mouth sores. Creams are used to treat skin and genital sores. The medicine usually contains corticosteroids, which reduce inflammation, or an anaesthetic, which relieves pain.

Oral Medicine

Doctors also prescribe medicines taken by mouth to reduce inflammation throughout the body, suppress the overactive immune system, and relieve symptoms. Doctors may prescribe one or more of the medicines described below to treat the various symptoms of Behçet’s disease.

Corticosteroids—Prednisone is a corticosteroid prescribed to reduce pain and swelling throughout the body in people with severe joint pain and inflammation, skin sores, eye disease, or central nervous system symptoms. Patients must carefully follow the doctor’s instructions about when to take prednisone and how much to take. It is also important not to stop taking the medicine suddenly because it alters the bodies production of the natural corticosteroid hormones. Long-term use of prednisone can have side effects such as osteoporosis, weight gain, delayed wound healing, persistent heartburn, and elevated blood pressure. However, these side effects are rare when prednisone is taken at low doses for a short time. It is important that patients see their doctor regularly to monitor possible side effects.

Immunosuppressive drugs—Medicines (including corticosteriods) that help control an overactive immune system, such as is the case in people with Behçet’s disease, reduce inflammation throughout the body and can lessen the number of flares. Doctors may use immunosuppressive drugs when a person has eye disease or central nervous system involvement. These medicines are very strong and can have serious side effects. Patients must see their doctor regularly for blood tests to detect and monitor side effects.

Depending on the person’s specific symptoms, doctors may use one or more of the following immunosuppressive drugs:
Azathioprine—Most commonly prescribed for people with organ transplants because it suppresses the immune system, azathioprine is now used to treat uveitis and central nervous system involvement in Behçet’s disease. This medicine can upset the stomach and may reduce the production of new blood cells by the bone marrow.

Chlorambucil—Doctors use chlorambucil to treat uveitis and meningoencephalitis. People taking chlorambucil must see their doctor frequently because it can have serious side effects, such as permanent sterility and cancers of the blood. Patients need regular blood tests to monitor blood counts of white cells and platelets.

Cyclosporine—Like azathioprine, doctors prescribe this medicine for people with organ transplants. When used by patients with Behçet’s disease, cyclosporine reduces uveitis and central nervous system involvement. To reduce the risk of side effects, such as kidney and liver disease, the doctor can adjust the dose. Patients must tell their doctor if they take any other medicines, because some affect the way the body uses cyclosporine.

Colchicine—Commonly used to treat gout, which is a form of arthritis, colchicine reduces inflammation throughout the body. The medicine is sometimes used to treat eye inflammation and skin symptoms in patients with Behçet’s disease. Common side effects of colchicine include nausea, vomiting, and diarrhoea. The doctor can decrease the dose to relieve these side effects.

Other medications can be used If these medicines do not reduce symptoms, doctors may use other drugs such as cyclophosphamide and methotrexate. Cyclophosphamide is similar to chlorambucil. Methotrexate, which is also used to treat various kinds of cancer as well as rheumatoid arthritis, can relieve Behçet's symptoms because it suppresses the immune system and reduces inflammation throughout the body. Make sure you are aware of when and how to take your medication and any known side effects. The drugs name must appear clearly on the medications label, but may not mean much to you.

A list of known medications used for Behcet's disease can be found here.

Rest and Exercise

Although rest is important during flares, doctors usually recommend moderate exercise, such as swimming or walking, when the symptoms have improved or disappeared. Exercise can help people with Behçet's disease keep their joints strong and flexible.

If you need more advice about your medication you can ask your pharmacist.

For the doctor to get a better understanding of how the disease is effecting you personally, he/she may ask you to attend when you are having a flare or your symptoms are at there worse. Indeed you may want to show him/her at your worse so that a suitable course of treatment can be planned.
It may also be the case that you will need to be monitored for any side effects depending on what course of treatment and medication you are currently receiving.
The treatment may need an initial period of working its way into your system, so you may have to be patient with the course of treatment being prescribed.
There are a number of treatments for Behcet's disease at the moment. So if one course of treatment does not work for you, there may very well be an alternative.

Prescriptions in the UK. If you are on certain types of social security benefits you may be entitled to free prescriptions, if not you can by prepayment certificates, to help reduce the costs involved in purchasing your medication.
If you need a lot of prescriptions, but are not entitled to them free, you can reduce the cost by buying a prepayment certificate for four months or a year. It saves you money if you need more than five prescription items in four months or 14 items in a year. You apply for a certificate on form FP95 (EC95 in Scotland) which you can get at the benefits agency, post office or chemist. A refund can be given if you buy a prepayment certificate and then, within a month, qualify for free prescriptions.

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