Treatment Options for Ulcerative Colitis

Medication is one of many options to help treat ulcerative colitis.

Medication, surgery, and alternative therapies are all valid forms of treatment for UC.
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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)

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


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