Treatment for ulcerative colitis depends mainly on how bad the disease is. It usually includes medicines and changes in diet. A few people have symptoms that are long-lasting and severe, in some cases requiring more medicines or surgery.
If you don't have any symptoms or if your disease is not active (in remission), you may not need treatment. But your doctor may suggest that you take medicines to keep the disease in remission.
If you do have symptoms, they usually can be managed with medicines to put the disease in remission. It often is easier to keep the disease in remission than to treat a flare-up.
Mild symptoms may respond to:
- Antidiarrheal medicines.
- Enemas or suppositories that contain medicine.
- Aminosalicylates. These medicines relieve inflammation in the intestines. They are also taken to keep the disease in remission.
- Steroid medicines. Your doctor may prescribe these for a few weeks to control active disease.
- Changes in your diet.
Moderate to severe symptoms
These symptoms usually require steroid medicines to control inflammation. The dose you need may be higher than that needed to treat mild symptoms. When inflammation goes away, you will take aminosalicylates to keep the condition in remission.
Severe symptoms also may be treated with:
- Immunomodulator medicines or cyclosporine. These strong medicines suppress the immune system to prevent inflammation.
- Biologics. They block the inflammatory response in your body and help reduce the inflammation in your colon. They may be used if other medicines don't control your symptoms.
- Surgery. Removal of the large intestine (colon) cures ulcerative colitis. But surgery may not cure all of the problems that the condition can cause in other areas of the body, such as the liver and joints. Surgery also is done to treat problems such as bleeding or toxic megacolon.
Treatment in the hospital
You may need treatment in the hospital if you have severe ulcerative colitis with symptoms outside the digestive tract, such as fever or anemia. Treatment includes replacing fluids and electrolytes lost because of severe diarrhea.
Your doctor will want to see you for a follow-up visit about every 6 months while your condition is stable. You'll need to see the doctor more often if you are having problems. Many people are so familiar with their condition that they can handle minor flare-ups on their own. In some cases, you may be able to talk with your doctor on the phone for minor problems.
If you are taking medicines, you may need to have lab tests regularly.