Ulcerative colitis (UC) causes inflammation and sores in the lining of your large intestine (colon).
Over time, the disease can permanently damage your colon and lead to complications such as severe bleeding or a hole in the colon.
Drug treatments can help prevent your immune system from overreacting and bring down inflammation in your colon.
Treatment also helps relieve symptoms like diarrhea and bleeding and prevents you from getting serious complications of the disease.
Talk with your doctor about all of your treatment options. It’s important to stick with the medication your doctor prescribes. Only by taking your medication can you manage your symptoms and stay in remission long term.
Here are 12 things you should know about treatment for UC.
UC treatment includes these drugs:
- 5-aminosalicylic acid (5-ASA) drugs such as mesalamine
- steroid drugs such as prednisone, prednisolone, and budesonide
- immunosuppressants such as 6-mercaptopurine (6-MP) and azathioprine
- biologics such as infliximab (Remicade) and adalimumab (Humira)
- janus kinase (JAK) inhibitor such as tofacitinib (Xeljanz) and upadacitinib (Rinvoq)
- a monoclonal antibody like vedolizumab (Entyvio)
Your doctor will help you choose a treatment based on three factors:
- the stage of your UC (whether it’s active or in remission)
- how much of your intestine the disease affects
- how severe your condition is
Mild UC is treated differently than severe forms of the disease.
UC isn’t curable. Its symptoms come and go. You’ll have periods of symptoms called flare-ups. They’ll be followed by symptom-free periods called remissions that last for months or years.
Treatment for UC aims to do two things:
- put you into remission
- help keep you in remission and prevent your symptoms from coming back
If you have mild diarrhea, rectal pain, or bleeding, your doctor might prescribe topical 5-ASA or corticosteroids. You rub these treatments onto your rectum to help bring down inflammation in the area.
The downside of treatment is that it can cause side effects. The side effects depend on the drug you take.
Common side effects from the 5-ASA drugs include:
- headaches
- nausea
- cramps
- gas
- watery diarrhea
- fever
- rash
Common side effects from steroid drugs include:
- increased appetite
- weight gain
- acne
- fluid buildup
- mood swings
- trouble sleeping
Biologic drugs can make it harder for your body to defend itself against infections.
Your doctor should monitor you closely while you’re on these drugs. If your side effects are severe or unbearable, you may need to switch to another medication.
Everyone responds differently to UC treatments.
Some people will need more than one drug to manage their symptoms. For example, your doctor might prescribe both a biologic and an immunosuppressant medication.
Adding on another drug can increase the effectiveness of your treatment. But taking more than one medication can also increase the number of side effects you experience.
Your doctor will balance your need for symptom control with possible risks of treatment when choosing a medication for you.
Studies suggest that
If a drug leads to remission, the person will continue to take it. If they stop, the symptoms may return.
Going into remission doesn’t mean your treatment ends. You’ll have to keep taking medication long term to help keep your disease well managed and prevent a relapse.
You may be able to go on a lower dose of the drug once your disease is in remission.
UC has been linked to harmful bacteria in the gut. Probiotics are beneficial bacteria that help get rid of bad germs. Adding these supplements to your treatment could help keep you in remission.
No all probiotics are the same, however, and not all of them have evidence to show they can help with UC. People should speak to their doctor before using this option.
There’s no evidence that following a strict diet can put you into remission or keep you there. In fact, cutting out certain foods could prevent you from getting the nutrients you need to stay healthy.
You may want to avoid certain foods — like dairy products — if they seem to aggravate your symptoms. However, talk with your doctor or a dietitian before making any major changes to your diet.
Between one-third and one-quarter of people with UC won’t see any relief with medication alone. Surgery to remove the colon may be considered. Surgery is also necessary if a hole develops in the colon.
If you have severe diarrhea or bleeding and your disease isn’t responding to treatment, you may need to be admitted to a hospital for a short stay.
The doctors and other medical staff will give you fluids to prevent dehydration. You’ll also get medications to help relieve your symptoms.
Once you find a drug that works well for you, you’ll have fewer flare-ups and more remissions.
Thanks to new and better medical treatments, most people with UC can keep their disease well managed and live active lives.