Ulcerative Colitis Treatment Options

Coping with ulcerative colitis is no easy thing. The chronic disease, which affects approximately 250,000 to 500,000 people in the U.S., causes inflammation and sores in the lining of the colon and rectum. As the inflammation worsens, the cells that line these areas die off, resulting in bleeding, pus and diarrhea. The condition can cause fever, anemia, fatigue, joint pain, appetite loss, weight loss, skin lesions and nutritional deficiencies. Children can experience stunted growth.

The exact cause of ulcerative colitis is unclear, though many experts believe it results from an abnormality of the immune system and an inability to handle bacteria in the digestive tract. A doctor may request a blood test, stool sample, s, barium enema and colonsocopy to determine whether the problem is ulcerative colitis rather than Crohn’s Disease, diverticular disease or cancer. Biopsy diagnosis of ulcerative colitis should be confirmed by biopsy (sampling) of tissue during colonoscopy.

If you’re diagnosed with ulcerative colitis, it’s vital to map out a treatment therapy that controls and prevents attacks so that your colon can heal. Because the symptoms and effects of the disease vary, there’s no single treatment that works for everyone. According to the National Institute of Health, treatments center on four key areas:

Diet and Nutrition

It’s best to consume smaller amounts of food throughout the day and avoid raw and high-fiber foods such as nuts, seeds, beans and whole grains. Fatty, gassy and greasy foods also contribute to inflammation and pain. Sipping water throughout the day can aid in digestion and reduce inflammation.

Stress

Anxiety and nervousness can worsen symptoms. Exercise and relaxation techniques that help you manage and reduce your stress levels can prove helpful. These include biofeedback, massages, meditation and therapy.

Medication

A doctor may prescribe drug therapy to induce or maintain remission. Although several types of drugs exist, these fall into three primary categories. 

• Aminosalicylates. These drugs contain 5-aminosalicyclic acid (5-ASA), which helps control inflammation in the intestine. They typically take three to six weeks to work. However, they may cause side effects, including nausea, vomiting, heartburn, diarrhea, and headache.

• Corticosteroids. This group of steroid drugs—including prednisone, budesonide, methylprednisone, and hydrocortisone—reduce inflammation. They’re often used for patients suffering from moderate to severe ulcerative colitis, including those who haven’t responded favorable to 5-ASA drugs. Corticosteroids can be administered orally, intravenously, through an enema or in a suppository. Side effects include: acne, facial hair, hypertension, diabetes, weight gain, mood swings, bone mass loss, and an increased risk of infection. Consequently, steroids are ideally used on a short-term basis to temper a flare of ulcerative colitis, rather than as a medication that is taken every day to control symptoms. Some UC is so severe that patients end up on a daily dose of steroids because they are required to allow the patient to maintain a normal lifestyle.

• Immunomodulators. These drugs, including azathioprine and 6-mercapto-purine (6-MP), reduce inflammation of the immune system—though they can take as long as 6 months to work effectively. Immunomodulators are administered orally and typically used for patients that don’t respond favorably to 5-ASAs or corticosteroids. Potential side effects include: pancreatitis, hepatitis, a reduced white blood cell count, and an increased risk of infection.

Surgery

If other forms of treatment fail, you may be a candidate for surgery. An estimated 25 to 40 percent of ulcerative colitis patients eventually have their colons removed as a result of severe bleeding and illness—or increased risk of cancer. Two types of surgeries exist, ileostomy and total proctocolectomy and ileal-anal pouch:

• Total proctocolectomy with Ileostomy. A surgeon creates a small opening, or stoma, from the abdomen, attaches the small intestine, and places a pouch at the beltline area to collect waste. The patient empties the pouch as it fills up.

• Total proctocolectomy and Ileal pouch-anal anastomosis. A surgeon removes the colon along with the inside of the rectum. The outer muscles of the rectum remain intact. The surgeon creates a pouch from the ileum (a portion of the small intestine) so that the patient can pass waste through the anus. Possible side effects and complications include watery bowel movements and inflammation of the pouch.

If you’ve been diagnosed with ulcerative colitis, avoid nonsteroidal anti-inflammatory drugs (NSAIDs), which may make symptoms worse. In addition, submit to an exam every year or two due to an increased risk of cancer. Map out a strategy with your doctor. With the right approach, it’s possible to cope with ulcerative colitis and live a normal lifestyle.