Medications for Ulcerative Colitis
Several medications, including sulfa drugs, corticosteroids, immunosuppressive agents and antibiotics, are used to reduce inflammation of the bowel tissue, allowing it to heal and relieve symptoms of ulcerative colitis.
- 5-aminosalicylic acid (5-ASA). Mesalamine, balsalazide, and sulfasalazine are principal medications in the treatment of ulcerative colitis. Let your doctor know if you are allergic to sulfa before taking this drug. He or she can prescribe a sulfa-free 5-ASA.
- Corticosteroids. These anti-inflammatory drugs can be used when 5-ASA is ineffective. Corticosteroids are also used to treat people who have more severe disease. The use of corticosteroids is limited by side effects and the potential of long-term complications. In general, corticosteroids are used for short periods of time to cause remission. Remission is maintained with a 5-ASA medication.
- Immunosuppressants. If corticosteroids or 5-ASA are not effective, immunosupressants, such as 6-mercaptopurine (6-MP), azathioprine (Imuran), tacrolimus (Prograf), or cyclosporine-A may be prescribed.
- Tumor Necrosis factor. These drugs prevent the cytokine from binding to cells and exerting a negative biological effect. This class of drugs includes inflixmab (Remicade) and adalimumab (Humira).
Diet Changes for Ulcerative Colitis
While foods appear to play no role in causing ulcerative colitis, certain foods may cause more symptoms when the disease is active. Your doctor may suggest dietary recommendations depending on your symptoms. Vitamins or nutritional supplements may also be suggested by your doctor.
Surgery for Ulcerative Colitis
Surgery for ulcerative colitis, in which the diseased section or entire colon is removed, may be necessary when drugs are not effective or if you have significant progression of symptoms or severe complications of the disease.
If the entire colon is removed, the operation most often creates an opening, or stoma, in the abdominal wall, to which a bag is attached (called a permanent ileostomy or Brooke ileostomy). The tip of the lower small intestine is brought through the stoma. Wastes pass through this opening and collect in an external pouch, which is attached to the stoma and must be worn at all times.
The pelvic pouch, or ileal pouch anal anastomosis (IPAA), is a newer procedure that does not require a permanent stoma. In this sugery, the colon and rectum are removed, and the small intestine is used to form an internal pouch or reservoir that will serve as a new rectum. This pouch is connected to the anus. The reservoir is called a J-pouch. This procedure is frequently done in two operations and requires a temporary ileostomy in between.
The continent ileostomy (Kock pouch) is an option for people who would like their old-style ileostomy converted to an internal pouch and for people who don't qualify for the IPAA procedures. In this procedure, there is a stoma but no bag. The colon and rectum are removed, and an internal reservoir is created from the small intestine. An opening is made in the abdominal wall, and the reservoir is then joined to the skin with a nipple valve. To drain the pouch, you insert a catheter through the valve into the internal reservoir.
There are also other techniques that are available. All surgeries carry some degree of risk and complications. If you have been told you need surgery to treat ulcerative colitis, you may want to seek a second opinion to ensure the treatment prescribed is the most appropriate option. Make sure your diagnosis is confirmed by experts at an institution experienced in identifying and treating digestive disorders.