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What Medications Are Used to Treat Ulcerative Colitis?

Medication plays an important role in the treatment of ulcerative colitis. Learn about five types of medication that can help control inflammation.

What Medications Are Used to Treat Ulcerative Colitis?

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). When a person has UC, the inner lining of the colon (the large intestine) and the rectum become inflamed. UC also causes sores (called ulcers) to form on the inside of the colon. The disease typically follows a cycle of remission and relapse, where symptoms flare-up at times and then go away at other times.

There is no cure for UC, but there are treatments that can help control and manage the condition. The main goal of treating UC is to keep the disease in remission. The specifics of a treatment plan will vary from person to person, but typically involve avoiding triggers (things that make symptoms worse), an overall healthy lifestyle, and medications to control inflammation.

Below is a look at the different medications used to manage UC.

Aminosalicylates
Aminosalicylates are anti-inflammatory drugs that reduce inflammation in the colon and rectum. They contain a compound called 5-aminosalicylic acid and are also called 5-ASA medications. There are several different aminosalicylates that may be prescribed for IBD, some which are taken as oral medications, others which are taken as enemas or suppositories. These are often the first-line therapy for mild-to-moderate UC.

Corticosteroids
Corticosteroids are a category of anti-inflammatory drug that are used to treat a number of inflammatory conditions, including UC. These drugs are synthetic but are similar to a hormone called cortisol that is produced in the body. Corticosteroids can cause serious side effects if used for long periods of time, but may be prescribed for short durations to reduce inflammation. Different corticosteroid drugs are taken in different ways—some are oral medications, others are suppositories, and others are given with an intravenous (IV) infusion.

Immunomodulators
UC is an autoimmune disease—a disease where the body’s immune system attacks healthy tissue, causing damage and inflammation. Immunomodulators or immunosuppressant drugs reduce and control inflammation by suppressing the immune system. Immunomodulators may be used in combination with other therapies, including biologic therapies.

Biologic therapies
Biologics are typically used for moderate-to-severe cases of ulcerative colitis. These drugs also act on the immune system to interrupt the inflammatory process. However, unlike immunosuppressant drugs, biologic drugs do not act on the immune system as a whole, but act on specific proteins involved in the inflammatory process. Many biologic drugs are given as an injection, and some can be self-administered or administered at home. Others are given in a healthcare setting with an IV infusion.

Janus kinase (JAK) inhibitors
JAK inhibitors are another type of drug that act on the immune system to control inflammation. JAK inhibitors work by blocking pro-inflammatory chemicals in the body. They are also used to treat rheumatoid arthritis. JAK inhibitors are taken as oral medications.

Choosing a treatment
UC is a different experience for every person. People experience different patterns of inflammation, different symptoms, and different severity of symptoms. There is no best treatment, only a treatment that is best for a particular person at a particular time.

If you have UC, the best thing you can do is work with a healthcare provider who specializes in the treatment of IBD, who can prescribe an appropriate treatment plan.

Medically reviewed in November 2020.

Sources:
Elsevier Patient Education. "Ulcerative Colitis, Adult."
UpToDate. "Patient education: Ulcerative colitis (Beyond the Basics)."
American Academy of Family Physicians. "Patient Education: Inflammatory Bowel Disease (IBD)."
Crohn's and Colitis Foundation. "Medication Options for Ulcerative Colitis."
Mayo Clinic. "Ulcerative colitis."
Crohn's and Colitis Foundation Fact Sheet. "Aminosalicylates."
Maia Kayal and Shailja Shah. "Ulcerative Colitis: Current and Emerging Treatment Strategies." Journal of Clinical Medicine, 2019. Vol. 9, No. 1.
National Cancer Institute. "Corticosteroid."
Cleveland Clinic. "Corticosteroids."
Crohn's and Colitis Foundation Fact Sheet. "Immunomodulators."
Crohn's and Colitis Foundation Fact Sheet. "Biologics."
Crohn's and Colitis Foundation Fact Sheet. "Janus Kinase Inhibitors (JAK Inhibitors)."
Przemyslaw J. Kotyla. "Are Janus Kinase Inhibitors Superior over Classic Biologic Agents in RA Patients?" BioMed Research International, 2018.

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