Your doctor will work hand in hand with you to come up with treatments for ulcerative colitis that will work for you.
This plan will likely be changing over time, depending on whether your disease worsens or you go into remission for an extended period.
Available treatment options include medication, dietary changes, and surgery if necessary. (1)
The goal of treatments for ulcerative colitis are:
- Treating acute attacks
- Inducing remission
- Prolonging disease remissions (2)
At first, your doctor will recommend medication to treat your ulcerative colitis. If drug therapy doesn’t work or an emergency comes, your doctor is will likely recommend surgery to remove a portion of your colon or all of it. In many cases, surgery for ulcerative colitis removes the entire colon. This natural means removing the rectum as well. (2)
Drug Therapy for Ulcerative Colitis
Most of the drugs prescribed to treat ulcerative colitis work by suppressing the inflammation in your colon. This allows the lining of your colon to heal and reduces the severity of symptoms such as diarrhea and abdominal pain. (1)
Typically, your doctor will prescribe one or more of the following drugs:
Other types of drugs your doctor may prescribe include:
Antibiotics If you’re running a fever, your doctor may prescribe these drugs to help prevent or treat an infection in your colon.
Antidiarrheal Medication This type of drug should generally be used only to treat severe diarrhea, since it raises the risk of developing toxic colitis, a dangerous complication.
Pain Relievers Your doctor may recommend Tylenol (acetaminophen) for mild pain.
Iron supplements Taking supplemental iron may be necessary if you have chronic intestinal bleeding. (3)
Aminosalicylates These drugs are used to treat disease flares, and can help prevent future ones when taken as maintenance therapy.
Because they work directly in the digestive system, aminosalicylates have a relatively low risk of negatively affecting other areas of the body.
Corticosteroids Also known simply as steroids, these drugs are used to treat active disease.
Because of their higher risk of side effects, steroids are usually reserved for moderate to severe disease, and shouldn’t be taken for long periods of time.
Immune System Suppressors These drugs work directly on the immune system to reduce inflammation. They’re used to treat disease flares, as well as prevent future ones when taken for maintenance therapy.
For many people with ulcerative colitis, a combination of immune system suppressors works better than one drug by itself. (3)
Surgery for Ulcerative Colitis
Ulcerative colitis can often be removed with surgery, but this way of treatment shouldn’t be taken unless it’s medically necessary.
About one-quarter to one-third of people with ulcerative colitis eventually become candidates for surgery, according to the Crohn’s & Colitis Foundation. (1)
Surgery may be necessary in the following situations:
- Abnormal cells, or dysplasia, in the colon, which puts you at high risk for colon cancer (2)
- Disease that doesn’t respond to multiple types of drug therapy
- Severe complications, like toxic colitis, a ruptured colon, or extensive bleeding
It’s still possible you’ll only have a portion of your colon removed, surgery for ulcerative colitis usually involves removing the entire colon and rectum. (4)
When your rectum is removed, the surgeon must create an alternative way of moving waste from your body.
For Instance, a proctocolectomy — removal of your entire colon and rectum — may require an ileostomy.
For this procedure, the surgeon creates a small opening in the abdominal wall and attaches the tip of the lower small intestine, the ileum, to the opening.
Waste expel from the body through this opening and must be collected in a pouch or bag. (1)
In an alternative approach — called ileoanal anastomosis — your surgeon may create an internal pouch out of the ileum and connect it to the anus. This allows you to pass stool fairly normally. (1)
Removing just a portion of your colon may be considered if you have limited disease. In most cases, though, this option doesn’t go far enough to address the problems that require surgery. (4)
Home Remedies for Ulcerative Colitis
A number of lifestyle changes can help control ulcerative colitis symptoms and reduce the stress of living with this chronic condition.
Make sure to see your doctor before trying any of the following approaches to managing your disease:
Eating Small, Frequent Meals Compared with eating three large meals each day, this lowers the likelihood of abdominal discomfort after eating.
Curcumin A component of the spice turmeric, this supplement has an anti-inflammatory effect and may help when taken along with conventional medication. More research is needed to prove its effectiveness for ulcerative colitis.
Probiotics These supplements help fortify the “good” bacteria that’s normally present in your intestines. In many cases, they have been shown to reduce symptoms of ulcerative colitis.
Foods that naturally contain probiotics include yogurt with live cultures and fermented foods, such as sauerkraut and miso.
Psyllium Seed This form of insoluble fiber, often sold as a laxative, helps maintain remission in some people. But it can be irritating to others, especially during a flare.
Soluble Fiber Foods high in this type of fiber, such as flaxseed and oat bran, help some people but cause constipation in others.
Mind-Body Practices Regularly engaging in meditation, tai chi, or yoga may reduce the stress of living with ulcerative colitis. (5)
Fish Oil These supplements, which contain high levels of omega-3 fatty acids, may help some people reduce symptoms or stay in remission.
The benefits of fish oil are disputed, though, and may be canceled out by certain drugs for ulcerative colitis.
Alternative Therapies for Ulcerative Colitis
Given the lack of a cure for ulcerative colitis and the difficulty of living with the disease, researchers continue to look for more and better treatments.
Nicotine patches appear to offer short-term symptom relief in some people, for reasons that remain unknown. They may be especially effective if the person used to be a smoker. (5)
Some studies indicate that acupuncture may help relieve symptoms of ulcerative colitis. This ancient Chinese practice can reduce stress and pain, and may be especially helpful in combination with your regular treatment. (5)