Making sure that you and your doctor are setting clear treatment goals is key to helping you get your UC controlled. Keep in mind that there’s no standard treatment that will work for all patients. Every person with UC has a different situation, and their treatment should be followed for their unique circumstances.
Individual factors that help you and your doctor determine a treatment approach include:
Location of the disease
in your body
Side effects of medication
(other diseases or medical
conditions you have)
It's important for you and your doctor to understand how severe your symptoms are. Beyond that, tests and procedures may be done to evaluate your disease activity and get an even better understanding of what’s really happening inside your body—and the inflammation that’s occurring—getting you to the treatment plan that’s right for you.
Medication for UC is designed to suppress your immune system’s abnormal inflammatory response—which is causing symptoms. When inflammation is suppressed, it offers relief from common symptoms (like diarrhea and abdominal pain).
There are 5 main categories of medications used to treat inflammatory bowel disease (IBD)—like UC.
Given either orally or rectally, these drugs work to decrease inflammation in the lining of the intestines and are usually used to treat mild to moderate UC symptoms. Sulfasalazine and mesalamine are examples of 5-ASA medications.
Metronidazole, ciprofloxacin, and other antibiotics may be used when infections occur, or to treat complications of ulcerative colitis.
These suppress the immune system to reduce inflammation by targeting a specific pathway. Certain biologics work by targeting specific inflammatory proteins that play a role in inflammation called cytokines. Others work by preventing certain white blood cells from getting into inflamed tissues.
Prednisone, prednisolone, and budesonide are included in this type of medication. They affect the body’s ability to initiate and maintain an inflammatory process—keeping the immune system in check. While effective for short-term flare-ups, they’re not recommended for long-term use.
These modify the body’s immune system activity to stop it from causing ongoing inflammation. These drugs (including azathioprine, 6-mercaptopurine (6-MP), and methotrexate) are usually used to maintain remission or for people who have only responded to steroids.
Talk to your doctor and see if this treatment for moderate to severe UC could be right for you.
There are also over-the-counter or non-prescription medications that can help relieve symptoms. Remember to always talk to your doctor before taking any of these medications, but know that depending on your disease severity, your doctor might recommend one or more of these:
Hi, I’m Dr. Millie Long and I’m a gastroenterologist at the University of North Carolina Inflammatory Bowel Diseases Center.
Understand your options. There’s no cure for Crohn’s disease or ulcerative colitis, but there are treatments available that directly address the inflammation that causes symptoms and help you to achieve and maintain remission. Treatment options for IBD include prescription medications and surgery, alongside adjustments to diet and nutrition. Prescription medication types include aminosalicylates, corticosteroids, immunomodulators, and biologic therapies. Some IBD medications, such as steroids are intended for short-term use. Other IBD medications such as aminosalicylates, immunomodulators and biologic therapies are intended for longer term use. There’s no one treatment that’s right for everyone. It’s important to talk to your doctor about a treatment plan that’s right for you. It’s also important to talk to your doctor about the risks and the benefits of each treatment. Be proactive and honest with your physicians and set goals that are best for you, to give you the best chance of achieving remission and reaching your Crohn’s disease and ulcerative colitis goals in the future.
Dr. Long discusses treatment options for patients with inflammatory bowel disease (IBD)—like Crohn’s or UC—and the importance of setting treatment goals.
Medication is often the first treatment option. But there are cases when people with UC might require surgery.
Surgery in ulcerative colitis usually involves removal of the colon and rectum. This is called a proctocolectomy, which might include:
It’s important to keep in mind that UC can still cause symptoms after surgery—so it's essential to continue to work with your doctor to keep up with the management of your disease. If you have treatment that works for you, it’s possible to achieve remission without surgery.
When it comes to people with ulcerative colitis, in a given year:
The longer a person with UC maintains symptom control, the less likely he or she is to experience a relapse, or flare-up, in the following year.
First and foremost, know that you and your doctor have the power to find the right treatment plan for you. While dealing with UC can definitely be difficult at times, never give up hope. And when it comes to your treatment plan, always keep the conversations open and honest with your care team.
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