Ulcerative Colitis Treatment Options

Medication

Medication for ulcerative colitis can suppress the inflammation of the colon and allow for tissues to heal. Symptoms including diarrhea, bleeding, and abdominal pain can also be reduced and controlled with effective medication.

In addition to controlling and suppressing symptoms (inducing remission), medication can also be used to decrease the frequency of symptom flare ups (maintaining remission). With proper treatment over time, periods of remission can be extended and periods of symptom flare ups can be reduced. Several types of medication are being used to treat ulcerative colitis today.

Combination Therapy

In some circumstances, a health care provider may recommend adding an additional therapy that will work in combination with the initial therapy to increase its effectiveness.  For example, combination therapy could include the addition of a biologic to an immunomodulator. As with all therapy, there are risks and benefits of combination therapy. Combining therapies can increase the effectiveness of IBD treatment, but there may also be an increased risk of additional side effects and toxicity. Your healthcare provider will identify the treatment option that is most effective for your individual health care needs.

Clinical Trials

Many people are unaware that a clinical trial is available as an option for treating their IBD. Through clinical trials, researchers find new ways to improve treatments and quality of life. Clinical trials are one of the final stages of a long and careful research process and it is only through clinical trials that new and improved treatment options for patients will become available. Visit the Clinical Trials Community to learn more about clinical trials and find a trial that may be right for you.

Diet & Nutrition

While ulcerative colitis is not caused by the foods you eat, you may find that once you have the disease, particular foods can aggravate the symptoms. It’s important to maintain a healthy and soothing diet that helps reduce your symptoms, replace lost nutrients, and promote healing.

For people diagnosed with ulcerative colitis, it is essential to maintain good nutrition because the disease often reduces your appetite while increases your body’s energy needs. Additionally, common symptoms like diarrhea can reduce your body’s ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.

Many people with ulcerative colitis find that soft, bland foods cause less discomfort than spicy or high-fiber foods. While your diet can remain flexible and should include a variety of foods from all food groups, your doctor will likely recommend restricting your intake of dairy foods if you are found to be lactose-intolerant.

Surgery

For approximately 20% of patients with ulcerative colitis, medical therapy is not completely successful or complications arise. Under these circumstances, surgery may be considered. This operation involves the removal of the colon (colectomy).

Depending on a number of factors, including the extent of the disease and the patient's age and overall health, one of two surgical approaches may be recommended. The first involves the removal of the entire colon and rectum, with the creation of an ileostomy or external stoma (an opening on the abdomen through which wastes are emptied into a pouch, which is attached to the skin with adhesive).

Today, many people are able to take advantage of new surgical techniques, which have been developed to offer another option. This procedure also calls for removal of the colon, but it avoids an ileostomy. By creating an internal pouch from the small bowel and attaching it to the anal sphincter muscle, the surgeon can preserve bowel integrity and eliminate the need for the patient to wear an external ostomy appliance.

Reference:

Singh, Siddharth, et al. "Contemporary Risk of Surgery in Patients with Ulcerative Colitis and Crohn's Disease." Clinical Gastroenterology and Hepatology, vol. 18, no. 11,  2020, pp. 2392-2401

Making Informed Decisions

If you're confused about all the medications and therapies out there, you are not alone. IBD is extremely complex, and it is important to review the risks and benefits of all treatment options with your doctor. Learn more about available tools and resources that can help you make informed decisions about your care.