Ulcerative colitis (UC) can have a significant impact on your life. This inflammatory bowel disease causes chronic inflammation and ulcers in your large intestines.
You may have led an active life before developing UC. Since receiving a diagnosis of UC, however, you may have limited activity outside the house because you’re fearful of having a flare-up in a public place.
Although this disease is unpredictable, several treatments can help manage symptoms and may induce remission. Remission is a period marked by no symptoms or flare-ups. It occurs when therapy successfully controls inflammation.
After diagnosing UC, your doctor may prescribe an anti-inflammatory medication as the first place to start. This medication treats symptoms of UC by reducing inflammation in your intestines.
If this medication doesn’t work, the next treatment is often an immunosuppressant drug. UC can develop from an abnormal immune system response to normal bacteria in your gut. These medications treat the condition by suppressing your immune system.
Your doctor may prescribe an immunosuppressant along with an anti-inflammatory medication.
Anti-inflammatory and immunosuppressant drugs don’t always bring about remission or adequately relieve symptoms of UC. Some people require a different therapy called biologics.
But even if your doctor recommends biologics, you may be hesitant to begin these medications. Learning more about this treatment may ease some of your worries.
What are biologics?
The main goals of UC treatment are getting to remission and staying in remission. Biologics are usually recommended for moderate to severe UC.
If you’ve had little success with other therapies for this disease, biologics may help. They’re unlike other types of medications for UC. This therapy attacks inflammation at its source by targeting the proteins responsible for causing inflammation in your intestines.
Currently, several different biologics are available for treatment of UC. Some of these you can self-administer by injection. Others require a visit to your doctor’s office for scheduled infusions. Only one can be taken by mouth.
Treatment options include:
- adalimumab (Humira), adalimumab-atto (Amjevita), adalimumab-adbm (Cyltezo) and golimumab (Simponi)
- infliximab (Remicade), infliximab-dyyb (Inflectra), infliximab-abda (Renflexis), and infliximab-qbtx (Ixifi)
- vedolizumab (Entyvio)
- tofacitinib (Xeljanz)
Like other types of therapies for UC, it can take a few weeks to see an improvement in your condition. Be patient.
Some people don’t notice an improvement until at least eight weeks after starting biologics, whereas others may notice immediate improvement.
What are the benefits of biologics?
Because of chronic diarrhea, frequent stools, and stomach pain, UC can interfere with the quality of your life.
Some individuals with mild UC respond well to treatment, and the disease goes into remission with an anti-inflammatory medication and lifestyle remedies. If you’re living with moderate to severe UC, however, you may only achieve remission with a biologic.
Remission not only alleviates common UC symptoms, it can also reduce your risk of certain complications of the disease. For example, frequent bouts of diarrhea and bloody stools increase the likelihood of dehydration and iron deficiency anemia.
Who should consider biologics?
Biologics may be ideal for those who don’t respond to conventional UC medications. But this therapy isn’t recommended for everyone. Talk to your doctor to see if you’re a good candidate for this particular treatment.
Biologics are similar to other immunosuppressant drugs because they also lower your immune system’s fighting ability and increase your risk of infection. As a result, biologics are typically not recommended for people who have certain diseases or a weakened immune system.
These conditions include:
- HIV and AIDS
- certain cancers
- multiple sclerosis
- heart failure
Your doctor may also discourage biologics if you’ve had an organ transplant.
In addition, biologics increase the risk of reactivating an inactive tuberculosis infection. As a result, you’ll need TB testing, and possibly treatment, before beginning therapy.
What are the risks of biologics?
Understanding risks associated with biologics and knowing how to reduce the risk of complications may calm your fears about treatment.
Mild side effects of treatment may include a rash. Some people also have redness, swelling, and itching at the injection site.
Because biologics can lower your immune system, there’s a greater chance of developing an upper respiratory tract infection, a urinary tract infection, skin infections, and other types of infections.
Signs of infection include:
- flu-like symptoms
Seek medical treatment if you have signs of infection during therapy.
You should take steps to lower your chances of developing an infection, so regular hand washing is important. Vaccinations are important, too.
Ask your doctor about an annual influenza vaccine and the pneumonia vaccine. If you have a history of chickenpox, talk to your doctor about getting a shingles vaccine. Also talk to your doctor about the HPV vaccine, if you haven’t been vaccinated.
Biologics may also raise your risk of skin cancer.
Protect yourself when outdoors: Apply sunscreen as directed and reapply it every two hours. Wear long-sleeved shirts, pants, and hats to protect your skin from too much sun exposure. You’ll also want to avoid using tanning beds.
Biologics are effective when other therapies for UC don’t work. This therapy can promote remission and improve the quality of your life, but you’ll need to continue treatment.
According to recent research, continuing biologics once symptoms disappear can keep the disease in remission.
UC isn’t a fatal disease, but its complications can be life-threatening, such as infection, injury to your colon, and worsening inflammation. So it’s important to do what you can to keep the disease under control.
Talk to your doctor about a treatment plan that works for you in order to have the best outcomes possible.