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Health A-Z

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Harvard Medical School

Treatment

Medications
Medications are very effective for improving the symptoms of ulcerative colitis. Most of the medications used work by preventing inflammation in the intestine.

A group of anti-inflammatory medicines called aminosalicylates are usually tried first. These medicines are chemically related to aspirin. They suppress inflammation in the gut and in joints. They are given:

  • By mouth

  • Directly into the rectum, as a suppository. A suppository is a waxy capsule.

  • As an enema (liquid that is squeezed from a bag or bottle into the rectum)

Aminosalicylates clear up symptoms in most people. But you may need to receive treatment for three to six weeks before you are free of symptoms.

Other, more powerful anti-inflammatory medicines are prescribed when the disease is very active or it cannot be controlled with an aminosalicylate. Often, the first choice of an anti-inflammatory drug is a corticosteroid, such as prednisone. Newer biologic agents are being prescribed more frequently today.

However, doctors are always concerned about side effects from the anti-inflammatory medicines, especially the increased risk of infection. So the goal is to reduce the dose and then stop the anti-inflammatory drug once the disease under control.

You may also be given medicines to decrease spasms of the colon. This makes symptoms less painful.

When symptoms are severe or when diarrhea causes dehydration, you may need to be hospitalized. You will get fluids and sometimes nutrition intravenously while the colon recovers.

Surgery
Surgery is used in people who have:

  • Severe symptoms that are not controlled by medicines

  • Unacceptable side effects from medicines

  • A very high risk of colon cancer because of extensive inflammation in the whole colon

After some surgeries, bowel movements will have to leave the body through an opening in the abdominal wall. This opening is called a stoma. The stoma replaces the function of the rectum. It may be connected to a drainage bag. The stoma may be used temporarily or permanently.

Newer surgical techniques allow many patients to keep the muscular layer of the rectum while still removing the rectal lining. This type of surgery has a cosmetic advantage. And, it allows bowel movements to pass through the rectum. Bowel movements are near normal, except that they are more frequent and contain more liquid.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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