What Is the Best Treatment for Ulcerative Colitis?

Reviewed on 6/18/2021

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflamed sores on the colon or large intestine. The best treatment for ulcerative colitis depends on the severity of the condition. Treatment typically includes medications to reduce symptoms. Surgery or surgical removal of the colon is reserved for severe cases and is the only permanent cure for ulcerative colitis.
Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflamed sores on the colon or large intestine. The best treatment for ulcerative colitis depends on the severity of the condition. Treatment typically includes medications to reduce symptoms. Surgery or surgical removal of the colon is reserved for severe cases and is the only permanent cure for ulcerative colitis.

Ulcerative colitis is a type of inflammatory bowel disease (IBD) in which the large intestine (colon) becomes chronically inflamed with sores. Ulcerative colitis typically affects the lower part of the colon and the rectum, but it can affect the entire colon. 

Another type of IBD is Crohn’s disease, which differs from ulcerative colitis in that it can affect any part of the gastrointestinal tract from the mouth to the anus. 

The best treatment for ulcerative colitis depends on the severity of the condition and how often a patient’s symptoms flare-up (worsen). Treatment is aimed at reducing symptoms, inducing remission (which is a period without symptoms), and maintaining remission.

Medications are usually used to treat ulcerative colitis to induce or maintain remissions and improve quality of life. 

Medications used to treat ulcerative colitis include:

  • Anti-inflammatory drugs 
    • Aminosalicylates (also called 5-ASAs) are used help to reduce inflammation and allow damaged tissue to heal
    • Systemic corticosteroids (prednisone, prednisolone, cortisone)
      • Also used to reduce inflammation, corticosteroids are more powerful than 5-ASAs, and may be used with or instead of 5-ASAs to treat flare-ups when 5-ASAs alone are not effective
      • Corticosteroids are not used long-term because they can cause potentially serious side effects
    • Topical corticosteroids
  • Immunomodulators
    • This treatment is used for mild or moderate flare-ups, or to maintain remission if symptoms do not respond to other medicines
    • They can be very effective in treating ulcerative colitis, but often take between 2 and 3 months to start working
  • Biologic therapies
  • Janus kinase inhibitors (JAK Inhibitors)
    • Used to treat moderate to severe ulcerative colitis if standard treatments or biologics have not worked or are not suitable

Surgery for ulcerative colitis is a last-resort used for severe cases of inflammation and life-threatening complications. Surgery usually involves removing the entire colon and the rectum, which is the only permanent cure for ulcerative colitis. 

What Are Symptoms of Ulcerative Colitis?

About half of all ulcerative colitis patients have mild symptoms, which may include:

Relapses, when inflammation and symptoms worsen (flares), can occur, followed by periods of remission when symptoms subside, that can last months to years. 

What Are Ulcerative Colitis Causes and Risk Factors?

The cause of ulcerative colitis is not known, but it is thought to involve an abnormal activation of the immune system in the intestines that results in chronic inflammation and ulcers in parts of the large intestine. 

Having a first-degree relative (brother, sister, child, and/or parent) who has ulcerative colitis is a risk factor for developing ulcerative colitis. The susceptibility to abnormal activation of the immune system is genetically inherited. 

What Tests Are Used to Diagnose Ulcerative Colitis?

Tests used to diagnose ulcerative colitis include: 


 

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Reviewed on 6/18/2021
References
https://www.uptodate.com/contents/ulcerative-colitis-beyond-the-basics?topicRef=15613&source=see_link

https://pubmed.ncbi.nlm.nih.gov/8613037/

https://www.crohnscolitisfoundation.org/

https://www.nhs.uk/conditions/ulcerative-colitis/treatment/