Treatment Options for Ulcerative Colitis
Medication is one of many options to help treat ulcerative colitis.
Your
doctor will work with you to develop a treatment plan for your
ulcerative colitis. This plan will likely change over time, depending on
whether your disease worsens or you go into remission for an extended
period.
Treatment options include medication, dietary changes, and surgery if necessary. (1)
The goals of treatment for
ulcerative colitis
are:
-
Treating acute attacks
-
Inducing remission
-
Prolonging disease remissions (
2
)
Initially,
your doctor will prescribe medication to treat your ulcerative colitis.
If drug therapy fails or an emergency develops, your doctor is likely
to recommend surgery to remove a portion of your colon or all of it. In
most cases, surgery for ulcerative colitis removes the entire colon.
This usually means removing the rectum as well. (2)
How
much is ulcerative colitis impacting your life? Are your treatment and
diet plans working for you? Here's how to check in before your next
checkup with your doctor.
Drug Therapy for Ulcerative Colitis
Most
drugs prescribed to treat ulcerative colitis work by suppressing the
inflammation in your colon. This allows the lining of your colon to heal
and reduces the severity of symptoms such as diarrhea and abdominal
pain. (1)
Typically, your doctor will prescribe one or more of the following drugs:
Aminosalicylates These drugs are used to treat disease flares, and can help prevent future flares when taken as maintenance therapy.
Because
they work directly in the digestive system, aminosalicylates have a
relatively low risk of negatively affecting other areas of the body.
Corticosteroids Also known simply as steroids, corticosteroids are used to treat active disease.
Because
of their higher risk of side effects, steroids are usually reserved for
moderate to severe disease, and shouldn't be taken for long periods of
time.
Immune System Suppressors These drugs work
directly on the immune system to reduce inflammation. They're used to
treat disease flares, as well as to prevent future ones when taken for
maintenance therapy.
For many people with ulcerative colitis, a combination of immune system suppressors works better than one drug by itself. (3)
Biologics These drugs are used to treat individuals with moderate-to-severe ulcerative colitis. Biologics are lab-made antibodies that target certain proteins in the body to stop them from causing inflammation. (1)
Other types of drugs your doctor may prescribe include:
Antibiotics If you're running a fever, your doctor may prescribe antibiotics to help prevent or treat an infection in your colon.
Antidiarrheal Medication This
type of drug should generally be used only to treat severe diarrhea,
since it raises the risk of developing toxic colitis, a dangerous
complication. (3)
Pain Relievers Your doctor may recommend Tylenol (acetaminophen) for mild pain.
Avoid Advil or Motrin (ibuprofen), Aleve (naproxen), and Voltaren (diclofenac), which can worsen ulcerative colitis symptoms. (2)
Iron Supplements Taking
supplemental iron may be necessary if you have chronic intestinal
bleeding. However, it's important to have your iron levels tested before
taking supplements. Excess iron can be toxic to the liver. (4)
RELATED: Three Ways to Treat Diarrhea
Surgery for Ulcerative Colitis
Ulcerative colitis
can often be eliminated through surgery, but this course of treatment
shouldn't be taken unless it's medically necessary.
About
one-quarter to one-third of people with ulcerative colitis eventually
become candidates for surgery, according to the Crohn's and Colitis
Foundation. (1)
Surgery may be necessary in the following situations:
- Disease that doesn't respond to multiple types of drug therapy
- Severe complications, like toxic colitis, a ruptured colon, or extensive bleeding
- Abnormal cells, or dysplasia, in the colon, which puts you at high risk for colon cancer (2)
While
it's possible you'll only have a portion of your colon removed, surgery
for ulcerative colitis usually involves removing the entire colon and
rectum.
When your rectum is removed, the surgeon must create an alternative way of moving waste from your body.
For example, a proctocolectomy - removal of your entire colon and rectum - may require an ileostomy.
In
this procedure, the surgeon creates a small opening in the abdominal
wall and attaches the tip of the lower small intestine, the ileum, to
the opening.
Waste exits the body through this opening and must be collected in a pouch or bag. (1)
In
an alternative approach - called ileoanal anastomosis - your surgeon
may create an internal pouch out of the ileum and connect it to the
anus. This allows you to pass stool fairly normally. (1)
Removing
just a portion of your colon may be considered if you have limited
disease. In most cases, though, this option doesn't go far enough to
address the problems that require surgery.
RELATED:
How to Care for a Loved One After Colitis Surgery
Home Remedies for Ulcerative Colitis
A
number of lifestyle measures can help control ulcerative colitis
symptoms and reduce the stress of living with this chronic condition.
Check with your doctor before trying any of the following approaches to managing your disease:
Eating Small, Frequent Meals Compared with eating three large meals each day, this lowers the likelihood of abdominal discomfort after eating.
Staying Hydrated Drink
plenty of fluids every day to keep hydrated, which is especially
important during flares. Water is the best option, while alcohol and
beverages with caffeine should be avoided, as they stimulate the
intestines and can make diarrhea worse. Carbonated drinks should also be
limited, as they produce gas. (3)
Probiotics These
supplements help fortify the "good" bacteria that's normally present in
your intestines. Some research suggests probiotics reduce symptoms
of ulcerative colitis.
A systematic review published in 2015 in the journal BioMed Research International found
that probiotics can have a positive effect in the maintenance and
remission periods of ulcerative colitis. However, other studies have
shown no benefit. (4)
More research is needed to determine the
effects of probiotics on people with IBD, and it's important to speak
with your doctor before starting a probiotic.
Curcumin A
component of the spice turmeric, this supplement has an
anti-inflammatory effect and some research suggests it may help when
taken along with conventional medication. A study published in August
2015 in Clinical Gastroenterology and Hepatology found
that patients taking the anti-inflammatory drug mesalamine along with
3,000 milligrams (mg) of curcumin capsules achieved remission faster and
recovered more quickly than those taking mesalamine and a placebo. (5)
However, more research is needed to prove curcumin's effectiveness for ulcerative colitis.
Fish Oil These supplements, which contain high levels of omega-3 fatty acids, may help some people reduce symptoms or stay in remission.
The benefits of fish oil are disputed, though, and may be canceled out by certain drugs for ulcerative colitis.
Mind-Body Practices Regularly engaging in meditation, tai chi, or yoga may reduce the stress of living with ulcerative colitis. (6)
RELATED:
How Probiotics Helped Me Manage UC
Alternative Therapies for Ulcerative Colitis
Given
the lack of a cure for ulcerative colitis and the difficulty of living
with the disease, researchers continue to look for more and better
treatments.
Nicotine patches appear
to offer short-term symptom relief in some people, for reasons that
remain unknown. They may be especially effective if the person used to
be a smoker. (7)
Some studies indicate that acupuncture may
help relieve symptoms of ulcerative colitis. This ancient Chinese
practice can reduce stress and pain, and may be especially helpful in
combination with your regular treatment. (3)
Last Updated: 12/17/2019
Source: https://www.everydayhealth.com/ulcerative-colitis/guide/treatment/
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