Ulcerative colitis treatments: Medications and other options

Ulcerative colitis can affect each person differently. Treatment depends on how severe the condition is and may include medication, surgery, and natural remedies.
Ulcerative colitis (UC) is an autoimmune condition that affects the large intestine, or colon. Autoimmune means that the immune system works against its own cells and tissues.
Symptoms can include:
loose or urgent bowel movements
persistent diarrhea
abdominal pain
bloody stools
a loss of appetite
fatigue or extreme tiredness
UC tends to follow a relapsing-remitting path. This means that symptoms get worse for a while and then become less severe. The condition affects everyone differently, and the best type of treatment depends on the severity of the condition. This article explains various treatment options for ulcerative colitis, including medications, surgical options, and natural remedies.
Medications for UC
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There is currently no cure for UC, but medications can help manage the condition. Current guidelines recommend long-term treatments that change the way that the immune system works. There are several options, and each can reduce the risk of a flare-up and lessen the severity of symptoms. They include:
guidelines recommend
TNF-α antagonists, such as infliximab (Remicade) or adalimumab (Humira)
Remicade
Humira
anti-integrin agents, such as vedolizumab (Entyvio)
Entyvio
Janus kinase inhibitors, such as tofacitinib (Xeljanz)
Xeljanz
interleukin-12/23 antagonists, such as ustekinumab (Stelara)
Stelara
immunomodulators, such as thiopurines and methotrexate
methotrexate
It is important to note that these drugs can have adverse effects. Speaking with a healthcare professional about the benefits and risks can be a helpful step. They will take various factors into consideration, including other ongoing medications, and create a treatment plan based on your needs.
Aminosalicylates, such as 5-aminosalicylates (5-ASAs), can help reduce inflammation and may be useful in treating UC symptoms.
Examples include:
balsalazide (Giazo)
balsalazide
mesalamine (Azacol)
olsalazine (Dipentum)
sulfasalazine (Azulfidine)
Azulfidine
If 5-ASAs do not work, a healthcare professional may prescribe corticosteroids to help reduce inflammation. However, long-term corticosteroid use can lead to severe adverse effects, and doctors try to avoid this whenever possible.
corticosteroids
Experts currently recommend focusing on long-term treatment to reduce the need for steroids.
currently recommend
Surgical treatments for UC
Some people with UC require surgery. This usually resolves the condition because surgical options involve removing the colon.
Surgery may be the best option if the person:
has colon cancer
colon cancer
has precancerous cells in their colon
has serious UC complications
finds that medication does not improve their symptoms
There are two types of UC surgical treatments.
surgical treatments
A proctocolectomy involves removing the entire colon, including the rectum.
involves removing
Doctors sometimes refer to an ileostomy as a stoma. It involves repositioning the end of the small intestine through an opening in the outside of the person’s stomach, just above the waistline.
ileostomy
The surgeon then connects an ostomy pouch, or stoma bag, to the opening. The contents of the small intestine collect in the bag, which is removable, rather than passing out through the anus. This is a permanent procedure.
This procedure also involves removing the colon and rectum. The surgeon then creates an ileoanal reservoir, which some call a J-pouch, at the end of the small intestine and connects it to the anus.
then creates
J-pouch
Waste then collects in the reservoir before passing through the anus. People who have this operation do not require a stoma.
Possible side effects of an ileoanal reservoir include:
more frequent, watery stools
fecal incontinence
fecal incontinence
infertility in females
infertility
Some people who have undergone the procedure develop pouchitis, which involves an infection developing in the lining of the ileoanal reservoir that leads to irritation or inflammation. Doctors usually treat the infection with antibiotics.
antibiotics
Natural treatments and home care
Some people with UC find the following supplements and home care strategies effective.
the following
While poor nutrition does not cause UC, it can affect symptoms.
nutrition
Certain foods and drinks can also be triggers, meaning that they worsen UC symptoms. Triggers are different for everyone. Keeping a food diary can help a person identify theirs.
A doctor may recommend switching to a low fiber eating plan while symptoms flare up. Suitable foods may include:
may recommend
refined grains, such as white bread and cornflakes
white rice or pasta
cooked vegetables without the peels, seeds, or stalks
lean meats and fish
eggs
For someone with UC, soft, bland foods may be easier to eat than spicy foods. However, it is still important to aim for a varied diet that includes all food groups.
may be easier
People commonly refer to probiotics as “friendly” or “good” bacteria. They boost the levels of beneficial gut bacteria. For example, a person may prefer probiotic supplements, yogurts, or drinks.
There is growing interest in using probiotics to treat or help ease UC symptoms. However, there are many types of probiotics, and it is still unclear regarding which are most likely to help and how effective these might be.
growing interest
Nevertheless, probiotics are likely safe to take, although they may cause mild side effects, such as gas or bloating, in some people.
Some people with UC may benefit from taking certain vitamins and minerals. For example, typically, anyone who takes steroids for UC for long periods may develop poor bone health, which may make calcium a beneficial mineral supplement.People with UC may also be at risk of developing anemia, so doctors may recommend iron supplements.
vitamins
calcium
anemia
iron supplements
If a person is considering adding vitamin or mineral supplements to their treatment plan, it is important that they talk with a healthcare professional first.
Typically, people use aloe vera to help wounds heal and relieve pain, but some people also believe that it can reduce inflammation internally. For example, some people with mild to moderate UC report that drinking aloe vera juice helps their symptoms. However, there is no scientific evidence for this. It is also worth noting that aloe vera can have a laxative effect when consumed.
aloe vera
Summary
UC is a long-term condition that affects the colon. It causes inflammation and ulcers, leading to symptoms such as diarrhea, abdominal pain, and fatigue.
Various medications and self-care strategies can help manage the condition, as can surgery. The best approach will depend on the severity of the condition.
It is recommended that individuals discuss their circumstances and symptoms with a healthcare professional before making changes to their UC treatment plan.
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Read the article in Spanish.