Ulcerative Colitis Treatment Options
How should my ulcerative colitis be treated?
Your doctor will develop a plan of action for treating your ulcerative colitis (UC). UC is usually treated by a gastroenterologist. Since UC is a chronic condition, try to find a doctor you feel comfortable talking with and listening to.
What's next after diagnosis? Once the diagnosis of UC has been confirmed, your doctor should be able to clearly define the extent or severity of your disease and will then design an appropriate treatment plan. Your doctor may want to know about your lifestyle or medication habits—in particular, how well you take medication and how medication fits into your life.
What are my ulcerative colitis treatment options? Although no medication cures ulcerative colitis, there are effective treatment options that don't stop at symptom control. Ask your doctor detailed questions about the benefits of these options.
What is the goal of UC treatment? According to the American Gastroenterological Association Guidelines, symptom relief and reduction of inflammation are both goals of UC treatment. This can help get you into remission and keep you there.
Why should you work closely with your doctor? Learn why open communication is so important. Click here.
Will I need just 1 medication?
A UC treatment pyramid is used to guide the choice of medicine. Depending on the severity of your UC and how well your body responds to certain treatments, your doctor may follow an established "treatment pyramid."
Adapted from Isaccs KL et al. Inflamm Bowel Dis. 2005;11:S3-S12.
How does the UC treatment pyramid work? The base of the pyramid coincides with effective treatments that are often used first because they are associated with fewer side effects. Doctors start people who have mild symptoms lower in the pyramid. If the disease and symptoms worsen, doctors employ more aggressive therapies, higher in the pyramid. Each person's UC is different, so your treatment will be individualized for you. Be sure to ask your doctor where your treatment fits in the UC treatment pyramid.
What are common treatments for UC?
The treatment of choice for mild to moderate UC is 5-ASA. Mesalamine, also known as 5-aminosalicylic acid or 5-ASA, is usually the first medication doctors prescribe for ulcerative colitis. Mesalamine is often the only medication people with UC need to control UC symptoms. It works to decrease inflammation. Some possible side effects of mesalamine may include headache, loss of appetite, nausea, and diarrhea. Recent advances have led to once-a-day formulations. Ask your doctor for more information about once-daily mesalamine-based medications.
Corticosteroids (or steroids) are used to reduce inflammation. However, because of their potency and potential for side effects, corticosteroids are generally used for moderate or severe flare-ups. They are not typically used for day-to-day maintenance or long-term treatment because of side effects such as weight gain, acne, facial hair, and mood swings.
Immunomodulators interrupt the immune system. Immunomodulators are typically used for patients who have not responded to 5-ASAs or steroids. These drugs are slow-acting, and it can take up to 6 months for you to get their full benefit.
Biologic therapies (or immunosuppressants) block the body's inflammatory response and prevent inflammation from occurring. They are sometimes used for unresponsive cases of UC, but more often they are reserved for severe cases of Crohn's disease. Possible side effects from immunosuppressants may include allergic reactions at the injection site, serious infections (including tuberculosis), worsening of congestive heart failure, and lymphoma.
A colectomy is surgery during which all or part of the colon is removed. A colectomy is generally reserved for the most serious cases of ulcerative colitis that do not respond to medical treatment or when complications, such as infections, arise. While this approach may sound extreme, many people with UC have had colectomies and, with proper management, are able to go on with their typical daily lives. If a colectomy is suggested for you, just ask to get all the details and talk to people who have benefited from this surgery.
Curious about what you can do in addition to treatment to better manage your UC? Get expert advice about the importance of diet and nutrition for ulcerative colitis.
