How is ulcerative colitis treated?


Ulcerative colitis treatment depends on disease severity. In severe cases, treatment is surgical, with the removal of the large intestine. If less severe, medical management is initially preferred, and includes medications that decrease inflammation, such as aminosalicylates, steroids and immunosuppressants.

While there is no cure for inflammatory bowel disease (IBD), lifestyle changes, medications and surgery may help reduce the signs and symptoms of IBD and help bring about remission (a period of time when symptoms fade).

Lifestyle changes include:

  • diet
  • smoking cessation
  • stress relief

Medications include:

  • antibiotics
  • anti-inflammatory agents
  • steroids
  • immunologic agents
  • biologic agents

Surgical options include:

  • A proctocolectomy—removal of the entire colon and rectum—is the most common surgery for ulcerative colitis. Since ulcerative colitis involves only the large bowel, this operation is considered curative. The end of the small intestine, after it is disconnected from the large intestine, is then used to create an ileostomy, or used for an ileoanal reservoir. An ileostomy (or stoma) is a small opening surgically created in the abdominal wall through which the end of the small intestine, the ileum, is brought to the skin's surface to allow waste to drain into a bag attached to the opening. Patients have their health and quality of life restored, and this remains a great option for many.
  • An ileoanal anastomosis, also called a pull-through operation or a J pouch, avoids the use of a permanent bag to drain waste. The surgeon removes the diseased colon and rectum, preserving the anal muscles necessary for bowel control. The ileum is used to create an internal reservoir (or pouch) that holds waste, and this is then surgically attached to the anal muscles. This enables the patient to pass waste (stool) via the anus. Bowel movements may be more frequent and watery than usual.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.