Treatment Options for Ulcerative Colitis

Optimal ulcerative colitis care often requires a holistic management approach that includes medications, dietary changes, and lifestyle modifications. Your doctor will work with you to develop a treatment plan that’s right for you. This plan will likely change over time, depending on whether your disease worsens or you go into remission.

• Treating acute attacks
• Inducing remission
• Prolonging disease remissions

Drug Therapy for Ulcerative Colitis

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 high risk of side effects, steroids are used only as a “bridge” to help UC symptoms while other, safer drugs are introduced. Steroids should not 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.

Small molecules are chemical compounds taken orally that also work on the immune system, but act differently from biologics.

These drugs are used to treat moderate to severe ulcerative colitis.

Immunomodulators are a second-line drug for treating ulcerative colitis. These drugs limit inflammation at its source in the immune system.

Other types of drugs your doctor may prescribe include:

Pain relievers Your doctor may recommend Tylenol (acetaminophen) for mild pain.

Surgery for Ulcerative Colitis

Ulcerative colitis can be cured through surgery to remove the entire colon, but this course of treatment shouldn’t be taken unless it’s medically necessary.

• 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

Surgery for ulcerative colitis usually involves removing the entire colon and rectum. Women of childbearing age should speak to their doctors to see if preserving part of their rectum would be preferable.

When your rectum is removed, continence is usually preserved. 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.

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.

Eat small, frequent meals. Compared with eating three large meals each day, this lowers the likelihood of abdominal discomfort after eating.

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.

Additional reporting by Ashley Welch and Jordan M. Davidson.