Ulcerative colitis is a painful condition that affects your digestive system. Specifically, ulcerative colitis causes ulcers and inflammation in the large intestine, rectum, stomach, and other parts of your GI tract. Along with these issues, ulcerative colitis can also cause diarrhoea, nausea, vomiting, bloody stool, and other unwanted digestive problems.
Unfortunately, there’s no known cure for ulcerative colitis. There are, however, plenty of medications and treatment options that can eliminate symptoms and keep flare-ups to a minimum. The goal of treatment is to reduce inflammation, eliminate ulcers, and keep your digestive tract working as it should. In general, medications are the preferred treatment for ulcerative colitis, but surgery is an option if medications are ineffective.
If you have ulcerative colitis, one of the first things your doctor will prescribe is anti-inflammatory medications. Most of the symptoms you are experiencing are due to inflammation in your large intestine, rectum, or stomach, so eliminating the inflammation is step one to treating your condition. In most cases, corticosteroids, such as prednisone and cortisone, are the preferred medications for reducing inflammation, especially in moderate to severe cases.
If corticosteroids and other anti-inflammatory medications are too strong, your doctor may recommend aminosalicylates to reduce inflammation. Common aminosalicylates include mesalamine and olsalazine, and they are typically taken orally or as a suppository. These medications are most effective for mild and moderate ulcerative colitis but may not be strong enough for more serious cases.
Biologics is the name of a group of medications that can prevent the immune system from creating certain proteins that cause ulcerative colitis flare-ups. These types of biologics, called tumour necrosis factor inhibitors and ustekinumab, block proteins, while another biologic, known as vedolizumab, blocks inflammatory cells. Your doctor will determine which biologics you need based on your symptoms, the cause of your ulcerative colitis, and other factors.
Because ulcerative colitis often stems from an overactive immune system, you will also benefit from taking immunosuppressants. As the name implies, immunosuppressants, such as azathioprine and tacrolimus, suppress your immune system, which can mitigate ulcerative colitis symptoms and flare-ups.
However, because it takes a while for immunosuppressants to take effect, you may need other medications in the meantime to manage flare-ups.
If you know you have ulcerative colitis, you can usually treat flare-ups with over-the-counter medications and home remedies. However, if you suffer from severe flare-ups, you may need other medications such as ciclosporin, JAK inhibitors, ozanimod, and biologics. You may also benefit from anti-diarrhoea medications and pain medications to solidify your stool and reduce your painful symptoms.
In serious situations where medications are not enough to treat your ulcerative colitis, you may need surgery. A proctocolectomy is the most common procedure for someone who has severe ulcerative colitis. During this procedure, a surgeon will remove your colon and rectum, permanently eliminating the potential for flare-ups.
However, because a proctocolectomy will eliminate your ability to pass stool, you will need to have an ileoanal pouch implanted to fulfil the functions of your rectum and colon. As you can see, a proctocolectomy is a very invasive surgery, and it is used as a last resort.
Ulcerative colitis is a painful and sometimes debilitating condition of the digestive system. It is a chronic condition that comes and goes and varies from one person to another. As such, it is important to seek an early diagnosis and treatment plan if you think you have ulcerative colitis. Only with the proper medications can you keep it under control and prevent future surgery.