Ulcerative colitis (UC) is a bowel condition that causes inflammation and ulcers in the large intestine and the rectum. It’s an autoimmune condition that often disrupts everyday life. Diarrhea, fatigue, and abdominal pain can limit your ability to function normally.
If you suffer from this chronic disease, you want to know what ulcerative colitis treatments are available. Most people will need to experiment with different treatment combinations to find what works best for them.
1. Lifestyle and Dietary Change
Lifestyle and dietary changes may be the first treatment your doctor recommends. Lifestyle modifications typically include:
Lifestyle and dietary changes are often combined with medications to relieve UC symptoms.
2. Anti-Inflammatory Medications
Anti-inflammatory medications are often the first treatments recommended, apart from lifestyle changes.
Aminosalicylates are typically used for people who experience mild to moderate UC symptoms. They may be helpful for those trying to keep their symptoms in remission. Examples include:
These drugs target the colon’s lining to reduce inflammation and keep symptoms at bay. Depending on which area of the colon is affected, your doctor will prescribe this medication to be taken orally, in suppository form, or by enema.
Corticosteroids are usually used in those with moderate to severe UC symptoms that don’t respond to other treatments. Examples include:
Corticosteroids reduce inflammation within the GI tract by suppressing the immune system. While effective, they are not meant to be used long-term. This is due to long-term side effects that can happen, like weight gain, high blood pressure, and osteoporosis. These medications can be given orally, by rectal suppository, or intravenously (IV).
3. Immunosuppressants
Immunosuppressants reduce inflammation in the GI tract. Because UC is an autoimmune disease, these drugs work because they decrease the immune system’s activity. Examples include:
They are most commonly used when corticosteroid treatments haven’t worked or have too many side effects. Immunosuppressants usually take several months to achieve their full effectiveness. They are available in both oral and injectible methods.
4. Biologics
Biologics work to reduce the symptoms of UC by targeting specific proteins in the immune system. Biologics work well but are often only used for those with moderate to severe UC. They can also be used for those who have not responded well to other treatments. Biologics cause an increased risk of infections, so they must be used cautiously. There are three different classes of biologics:
5. JAK Inhibitors
JAK inhibitors block an enzyme called Janus kinase. This enzyme contributes to the inflammatory process that causes ulcerative colitis. JAK inhibitors are used for people with moderate to severe symptoms and those who did not respond to biologic treatments.
Currently, the only FDA-approved Jak inhibitor is Tofacitinib (Xeljanz). While taking it, people should be closely monitored for infections and blood clots.
6. Small Molecule Inhibitors
Ozanimod (Zeposia) is a relatively new drug. It’s a small-molecule inhibitor used to treat moderate to severe ulcerative colitis. It works by keeping some lymphocytes (a type of white blood cell) in the lymph nodes so they don’t go into the gut and cause inflammation. This helps calm down the swelling and irritation in the intestines.
Zeposia is often used as an alternative for those who have not responded to other treatments.
7. Surgery
When ulcerative colitis is severe or has not responded to medications, surgery can be a curative solution. This is especially true in people who have developed complications like bowel perforation. Surgery usually consists of removing the colon and rectum. The small intestine is then rerouted to exit through a small opening in the abdomen. The stool passes through the opening into a collection bag.
There are many different treatment options available for ulcerative colitis. An experienced gastroenterologist is an invaluable partner in your ulcerative colitis journey. They can help you find the right combination of lifestyle changes and medications that work best to control your symptoms.
Don’t continue to live with ulcerative colitis – schedule an appointment today!
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