Treatment Options

It is important to research and communicate with your doctor, what treatment(s) - both short and long term is best suited for you, your lifestyle and personal beliefs.

Drug Therapy
Anti-inflammatory drugs are usually the first step in the treatment of ulcerative colitis (i.e. such as mesalamine) to control inflammation and induce remission. Corticosteroids (i.e. prednisone)are very effective but have significant side effects, such as increased susceptibility to infection, mood swings, anxiety, depression, elevated blood pressure, glaucoma, cataracts and osteoporosis.

Immune system suppressors
Drugs that suppress the immune system treat ulcerative colitis by blocking inflammation (i.e. Purinethol and Imuran). Side effects may include nausea, vomiting, liver problems or pancreatitis.

Other drugs (i.e. such as Remicade) was approved for use in ulcerative colitis by the FDA.

Surgery
Surgery is often the last resort if medication, dietary and other treatments are not reducing symptoms or if the patient has had UC for a long time, there is a higher risk of developing cancer.

Both conventional open surgery and minimally invasive (laparoscopic) surgeries are performed. Ileal-anal pouch surgery is most common: this procedure removes the entire colon and rectum The surgeon constructs a pouch from the end of the small intestine and attaches it to the anus which does not require an external bag to collect waste. Older procedures such as the Kock Pouch are still performed when the rectum/anus have been removed. This involves using a catheter to empty the internal pouch inserted from a small stoma (opening on lower part of the stomach). There have been complications with the nipple valve from slippage requiring additional revisions.

Proctocolectomy
This surgery also involves removing the colon and rectum. An opening (end-ileostomy) is created on the outside of the patient's body in the lower abdomen and requires a small bag over the opening to collect waste. Many patients have this surgery performed 1st, then a later surgery revision to a continent ileostomy (i.e.Kock pouch.)