Currently, the only cure for severe ulcerative colitis is surgical removal of the affected colon. Overall, treatment for ulcerative colitis is focused on reducing symptoms and increasing the possibility of long-term remission.

Types of Treatments

There are a variety of treatments for ulcerative colitis. These treatments are described in more detail below.

• Anti-inflammatory agents
• Immunomodulator drugs
• Immunotherapy
• Anti-diarrheal drugs
• Diet and nutrition therapy
• Surgery

Anti-inflammatory drugs – Anti-inflammatory drugs are often the first-line treatment for ulcerative colitis. Anti-inflammatory drugs for the treatment of ulcerative colitis may be given by mouth, enema, or suppository.

Anti-inflammatory drugs used for the treatment of ulcerative colitis may include:

• Baldalazide
• Budesonide
• Cololsalazine
• Mesalamine
• Prednisone
• Sulfasalazine

Immunomodulator drugs –Immunomodulators reduce inflammation by decreasing the body’s immune defenses.

Immunomodulator drugs used for the treatment of ulcerative colitis may include:

• Azathioprine
• Cyclosporine
• Mercaptopurine
• Tofacitinib

Immunotherapy, also called biologics – Immunotherapy targets the immune system, or the body’s natural defenses, to reduce inflammation.

Immunotherapy drugs used for the treatment of ulcerative colitis may include:

• Adalimumab
• Golimumab
• Infliximab
• Vedolizumab

Anti-diarrheal drugs – Anti-diarrheal medications, such as loperamide, may be recommended to manage severe diarrhea associated with ulcerative colitis. Anti-diarrheal medications should be used with caution under the care of a doctor.

Pain medication – Acetaminophen may be recommended for mild-to-moderate pain associated with ulcerative colitis.

Antibiotics – Antibiotics may be given for ulcerative colitis to treat bacterial infections of the digestive tract.

Diet and nutrition therapy – Changes in diet may be necessary to help reduce and manage the symptoms of ulcerative colitis, such as:

• Eating smaller meals more frequently
• Drinking more liquids
• Avoiding fizzy drinks, caffeinated beverages, alcohol, fried foods, high-fiber foods, high-fat foods, artificial food additives, dyes, and sweeteners, and lactose
• Vitamins and other supplements may also be given to treat nutritional deficiencies often associated with ulcerative colitis.

Surgery – For some patients with severe ulcerative colitis, surgery may be necessary.

Types of surgery used for the treatment of ulcerative colitis may include:

Removal of the entire colon and rectum, which can cure ulcerative colitis.

Ileal pouch anal anastomosis – In this surgery, a pouch is made from the small intestine and used to replace the rectum. This allows for normal passage of waste and avoiding having a permanent opening into abdomen called a stoma.

Ileal stoma – When an ileal pouch cannot be done, a permanent opening in abdomen called a stoma will be created and covered with the placement of a stool collection bag.

Proctocolectomy – A proctocolectomy involves the removal of the entire colon and rectum. Next, a permanent opening in abdomen called a stoma is created. A stool collection bag is placed over the stoma.

A proctocolectomy can also be performed with an ileoanal reservoir, which connects a portion of small intestine to the anus to create a pouch to replace the rectum.

New and Experimental Therapies

New and experimental therapies for the treatment of ulcerative colitis include:

• Etrolizumab
• Filgotinib
• Guselkumab
• Mesenchymal stem cells
• Mirikizumab
• Ozanimod
• Risankizumab
• Tofactitinib
• Upadactitinib
• Ustekinumab

Long-Term Follow Up

Ongoing, long-term follow-up is an essential part of treatment for patients with ulcerative colitis to monitor the disease’s progression and the effectiveness of treatment.

Sources

This content was written by the MediFind Medical Team. Last updated: 6/9/2022