Estimated reading time: 4 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
The rate of inflammatory bowel diseases like ulcerative colitis (UC) has been increasing. Unfortunately for those affected, the risk of developing another chronic disease is higher if you have either UC or Crohn's. While there is no cure, there are a number of treatments that can help manage symptoms, reduce flare-ups, and improve quality of life. Treating this condition is the best way to improve health and reduce the risk of getting any other illnesses. Here is an overview of the common medications and treatment options for ulcerative colitis.
Medication Options
The first line of defense against the effects of UC is medication. They aim to reduce inflammation, help the body heal, and manage symptoms like diarrhea, bleeding, and abdominal pain. They can be broken down into a few different categories.
Anti-inflammatories
Because UC is an inflammatory disease, anti-inflammatory medicines are usually the first choice for treatment. There are a few different types of anti-inflammatories.
- 5-aminosalicylates
- Corticosteroids
Immunosuppressants
Immunosuppressants, true to their name, help suppress the immune system and its inflammatory response. These are the most common.
- Cyclosporine
- Azathioprine
- Mercaptopurine
- Methotrexate
Biologics
These medications are specially engineered from living cells or antibodies. The cells are grown in a lab, and then special proteins are extracted to make the drug. The proteins then target specific receptors found on immune cells. This helps them directly attack the cells responsible for inflammation.
- Anti-tumor necrosis factor (TNF) agents
- Infliximab
- Adalimumab
- Golimumab
- Integrin receptor agonists
- Vedolizumab
- Interleukin inhibitors
- Ustekinumab
- Janus kinase (JAK) inhibitors
- Tofatinib
- Upadacitinib
- Ustekinumab
Other Medications
Outside of the previous categories, you may end up taking certain medications to treat specific symptoms of UC.
- Anti-diarrheal medications
- Pain relievers
- Antispasmodics
- Iron supplements
Sometimes, doctors may recommend a combination of therapies. For example, a biologic might be added to an immunosuppressant. While combining treatments can improve results, it may also increase the risk of side effects. Your doctor will tailor the treatment plan to your specific needs.
Surgical Options
In cases where medication and other treatments are not effective, surgery might be necessary. There are two main types of surgery a surgeon may perform. Both are proctocolectomies, in which both your colon and rectum are removed.
- Ileoanal Pouch (J-Pouch): This is the most common surgery for UC. In this, the colon is removed and a pouch is created from the end of your small intestine. This pouch is then connected to the anus, which lets you have bowel movements. This procedure means you will no longer have to wear a bag to collect stool.
- Ileostomy: An ileostomy creates a exit point for waste to leave your body into a small bag. The small intestine is diverted to an opening in the abdomen (stoma), where waste is collected. After this surgery, you will have an external ostomy pouch that must be worn.
Surgery can significantly improve quality of life but involves a recovery period and lifestyle adjustments. There are risks with any surgery, so be sure to consult with your doctors, including your gastroenterologist and colorectal surgeon, to weigh the treatment options before making any final decisions.
Diet and Nutrition
While no specific diet causes or cures UC, certain foods can make symptoms worse! Maintaining good nutrition is important because UC can affect your appetite and how you absorb nutrients. Here are some tips for helping control the condition.
- Eat soft, bland foods: These are easier on the digestive system. Eating softer foods can help relieve abdominal pain.
- Stay hydrated: Drink plenty of fluids, especially if you have diarrhea. People with UC can lose fluids much more quickly than those without. You should also keep an eye on your electrolyte levels.
- Monitor food triggers: Keep a food diary to identify foods that worsen symptoms. You want to avoid anything that will worsen inflammation.
- Change your routine: You may need to eat smaller, more frequent meals. Your body can better tolerate these. If you are having trouble getting the nutrients you need, consider supplements.
- Consult a dietitian: They can help create a balanced diet plan that meets your nutritional needs. What works for some might not work for others! Find a balance in collaboration with your care team.
There are several ways to manage ulcerative colitis. Medications, dietary adjustments, and sometimes surgery can help control symptoms. Work closely with your healthcare team to find the best treatment plan for you!
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