Ulcerative colitis - Choosing treatments

This page gives an overview of treatments. Use the pages that have now appeared in the left menu under Choosing treatments for more detail.

When it comes to treatments in ulcerative colitis, there are several options. These depend on which part of your gastrointestinal tractThe gut, which begins at the mouth and ends at the anus. is affected, the severity of your condition, the complications you may have developed and how well you have responded to previous treatments.

Ulcerative colitis can be treated with a combination of nutrition, lifestyle changes, drugs and possibly surgery.

Over time, the best treatments for your condition may change. Sometimes, new drugs and treatments become available and your doctor may recommend them to you.

It is important to attend appointments with your doctor as advised to monitor your symptoms and treatment because ulcerative colitis requires life-long attention. Even when you are in remission, it is still important to keep up with the therapy that your doctor has recommended.

The first stage of treatment for ulcerative colitis is to get the problems under control, called induction of remission. The second stage is to prevent problems from flaring up again, called 'maintenance of remission'.

Most people find that problems caused by ulcerative colitis can be successfully treated with medication. If this is not possible, surgery may be required.

Over time, the best treatments for your condition may change. Sometimes, new drugs and treatments become available and your doctor may recommend them to you. Learn more about new developments - On the horizon.

Medications

Medication can be very effective in relieving the symptoms, preventing recurrences and extending remission in ulcerative colitis.

There are several categories of medication, each covering a number of different drugs that act in various ways to help you to live with your condition, for example:

  • Treating the condition itself
  • Preventing recurrence of symptoms to maintain remission. You will usually take these medications all the time, even if you are feeling well
  • Controlling particular problems associated with your condition, such as diarrhoeaWhen bowel evacuation happens more often than usual, or where the faeces are abnormally liquid.. You may take these only when you need them.

Your doctor can explain about the choices of medications to you in detail.

Different drugs require different doses and schedules. It is possible that you will need to try several different combinations before finding the right combination and type for you. The aim is to keep you in remission without causing unwanted side-effects.

It is important that you follow your doctor's instructions exactly. You will have to remember to take your medication correctly, and at the right time and intervals. If you are away from home, you need to remember to take your medications with you.

Learn more about Medications.

If surgery is required, the aim of the surgeon will be to save as much of the healthy intestines as possible, allowing you to lead as healthy and normal a life as possible.

Other therapies for ulcerative colitis

Several other treatments have been suggested for ulcerative colitis. These include:

  • Nutritional therapy
  • Herbal medicines and supplements
  • Other options, such as relaxation, hypnotherapyAny form of psychotherapy that uses hypnosis. and acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points..

As in many other conditions, dealing with stressRelating to injury or concern. can help you to cope better with the pain and inconvenience associated with ulcerative colitis. Techniques that may help include relaxation exercises, meditation and yoga.

If you intend to use or are using any nutritional supplements or complementary therapies, it is best to discuss them with your doctor, to check that they will not affect your condition or any existing treatment you are receiving. Your doctor may suggest supplements or complementary treatments that might support, or complement, your current regime.

Learn more about nutritional therapy.

Surgery

For some people, ulcerative colitis can be managed with the right medication. In addition, diet and lifestyle changes can help. However, for others whose problems are not controlled by medication, it may be necessary to have surgery.

If surgery is required, the aim of the surgeon will be to save as much of the healthy intestines as possible, allowing you to lead as healthy and normal a life as possible.

Your surgeon can guide you in making an informed decision about which procedure is best for you. The type of complicationA condition that is linked to, or is a consequence of, another disease or procedure. you have, the area of the intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. affected, and the severity of your disease will affect this.

It is important that your surgeon is experienced in performing this type of surgery, so ask how many operations your surgeon performs and how good the success rates are.

Removing the whole of the large intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. cures ulcerative colitis completely. Operations to remove just a part of the large intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. (resection) are not suitable for use in ulcerative colitis, as the disease will return in the remaining tissue.

For ulcerative colitis, surgery options include:

  • Proctocolectomy (removal of the large intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. and rectum) and ileostomySurgery that involves bringing part of the small intestine, the ileum, through the abdominal wall. The intestinal contents are collected by a bag worn over the hole, or stoma.
  • Proctocolectomy and the creation of a pouch.

Surgery is not something to be taken lightly but it does have several important advantages:

  • As the large intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. is completely removed, the ulcerative colitis is cured
  • It may mean that there is no need to take medication
  • You will probably feel much better
  • Screening for cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. is not necessary.
  • These are major operations so will mean that you need to stay in hospital.

Complications of surgery

Ulcerative colitis can be cured completely by removing the large intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus.. As with any surgery, there is a possibility that complications may arise. With surgery for ulcerative colitis, these complications can include:

  • Poor wound healing
  • Infection
  • Adhesions
  • Leak from anastomosi
  • Stoma/pouch dysfunction
  • Pouchitis (inflammationThe body’s response to injury. of the pouch).

Learn more about surgery.

Ostomy bag

Some surgical procedures may result in you having to wear an ostomy bag (sometimes known as an ileostomySurgery that involves bringing part of the small intestine, the ileum, through the abdominal wall. The intestinal contents are collected by a bag worn over the hole, or stoma. or colostomySurgery that involves bringing part of the large intestine through the abdominal wall, through an opening called a stoma. Faeces are collected by a bag worn over the hole. bag). Although this may be thought to be unpleasant, the advantages of this type of surgery almost always outweigh the problems that were caused by the disease itself.

Learn more about coping with a stoma and ostomy bag.

Ulcerative colitis surgery and fertility

Surgery for ulcerative colitis may affect a woman's chances of becoming pregnant. If having children is important to you, discuss this with your doctor or specialist before having an operation.