UC is a lifelong condition. Although medications can't cure it, they can help keep flares under control. As you treat your UC, symptoms in other parts of your body will also improve.
Typical treatment for UC includes drug therapy and, in some cases, surgery.
Drugs that treat UC fall into several categories. Your doctor may try several different types of medications before finding the one that works best for you. Categories include:
Aminosalicylates (balsalazide, mesalamine, olsalazine, sulfasalazine). These drugs are a common choice for treating UC because they control inflammation. Doctors typically prescribe them for people with mild to moderate symptoms. You take them by mouth, as an enema or suppository, or both, depending on which parts of your colon are affected.
Corticosteroids (budesonide, hydrocortisone, methylprednisolone, prednisone). Also called steroids, these drugs both dial back the activity of your immune system and help lower inflammation in your body. Doctors usually wait to see if aminosalicylates work first before they prescribe steroids. But your doctor may start with steroids as your treatment if your symptoms are severe. You shouldn't use steroids long-term, though.
Immunomodulators (azathioprine, cyclosporine, mercaptopurine, tofacitinib). These drugs reduce inflammation by dampening the immune system response that turns on inflammation. They can take 3 weeks to a month to start working. Doctors usually prescribe them when aminosalicylates haven't worked.
Ozanimod (Zeposia) is a type of immunomodulator known as a sphingosine 1-phosphate receptor modulator. It keeps certain white blood cells, or lymphocytes, inside the lymph nodes so that they don't get into the central nervous system and cause inflammation.
Biologics. Adalimumab, golimumab, and infliximab are biologic medications called anti-TNF therapies. They dial back your immune system response by targeting specific proteins, called tumor necrosis factor (TNF), that turn on inflammation. You get these drugs through a shot or IV. Your doctor will typically use them only if no other medication is working.
Other types of biologics include:
Integrin receptor agonists
Janus kinase (JAK) inhibitors
- Tofacitinib (Xeljanz)
- Upadacitinib (Rinvoq)
Other medications. You might need something else to ease UC symptoms, such as:
- Acetaminophen for pain
- Antibiotics for infections
- Meds to ease diarrhea, such as loperamide
People with mild or moderate UC won't need surgery to treat their condition. But if your symptoms are severe and medications aren't helping, your doctor may recommend an operation to remove all or parts of your colon and rectum.
The two main types of surgery include:
Proctocolectomy with ileostomy. This is the most common operation for UC. A surgeon removes your entire colon and rectum. Then they make a small hole in the wall of your belly and attach the bottom part of your small intestine to that opening. After the surgery, you won't poop the way you did before. Your waste will come out of the new opening and drain into a bag, called an ostomy pouch.
Ileoanal anastomosis. In this surgery, a surgeon removes your whole colon and the tissue lining the inside of your rectum. You keep the outer muscles of your rectum. Your surgeon creates a "new" rectum from your small intestine and attaches it to your anus. This new pouch holds your stool. This allows you to poop much like you did before surgery. But bowel movements may happen more often and be more watery than before.
Surgery to remove your colon and rectum cures UC.
Diet and Nutrition
Though you can't make your UC go away with a special diet, you can stretch out the time between flares and have better control of your symptoms by focusing on how and what you eat each day. Filling up on certain foods and avoiding others can help heal your colon and replace vital nutrients you may be losing from symptoms of UC.