Ulcerative Colitis Treatments and Surgery – WebMD

How Is Ulcerative Colitis Treated?

Treatment for ulcerative colitis can include medicine, changes in your diet, or surgery. These treatments won't cure your ulcerative colitis, unless you have surgery that removes the colon and rectum, which is considered curative, but they can help ease your symptoms.

It's important to get treated for ulcerative colitis as soon as you start having symptoms. If you have severe diarrhea and bleeding, you might need to go the hospital to prevent or treat dehydration, reduce your symptoms, and make sure you're getting the right nutrition.

Your doctor may suggest several types of medicines to curb inflammation in your bowel, including sulfa drugs, corticosteroids, immunosuppressive agents, and antibiotics.

Newer medications being studied include a group called sphingosine 1-phosphate receptor modulators. These can be taken by mouth. Researchers think they may get around the anti-drug antibodies that sometimes form with medicationsgiven as a shot. Antibodies are proteins that cancel out viruses, bacteria, and other things your body doesnt recognize.

While food doesn't appear to play a role in causing ulcerative colitis, certain foods may cause more symptoms when your disease is active. Your doctor may suggest diet changes, depending on your symptoms. They may also recommend vitamins or nutritional supplements.

Some people get surgery to remove part or all of the colon. Your doctor may suggest this if your medicine isn't working, your symptoms get worse, or your ulcerative colitis leads to serious complications.

When you have an operation to remove your entire colon, the surgeon most often creates an opening, or stoma, in your belly wall. They attach a bag there and bring the tip of your lower small intestine through the opening. Waste passes through it and collects in a pouch, which gets attached to the stoma. You'd need to wear the pouch all the time.

A newer surgery, called a pelvic pouch or ileal pouch anal anastomosis (IPAA), doesn't create a permanent opening. Instead, a surgeon removes your colon and rectum, and your small intestine is used to form an internal pouch or reservoir that serves as a new rectum. This pouch is connected to the anus.

A procedure called a continent ileostomy (Kock pouch) is done if you want your external pouch converted to an internal one, or if you can't get the IPAA operation.

In this procedure, there is a stoma but no bag. Your surgeon removes your colon and rectum and creates an internal reservoir from your small intestine. They make an opening in your belly wall and join the reservoir to your skin with a nipple valve. To drain the pouch, you insert a catheter through the valve into the internal reservoir.

Other techniques are also available. All surgeries carry some risk and complications. If you have been told you need surgery to treat ulcerative colitis, you may want to get a second opinion to make sure you get the best option for you.

Call your doctor right away if you have:

You may consider these approaches in addition to what your doctor prescribes. But its important to talk to your medical team about any and all of them because some, like supplements, can interfere with treatments from your doctor. Lets take a look at a few:

Mind-body therapies: Stress and anxiety are well-known triggers for many people with ulcerative colitis, so it is not surprising that mind-body relaxation techniques could help. These techniques help nurture a healthy connection between your mind and body as well as between you and the outside world. In some cases, they encourage behavior changes in your everyday life. They may be worthwhile if only to lessen anxiety and depression linked to UC and improve quality of life. In addition, there is some evidence that yoga, meditation, and gut-centered hypnotherapy could help with some physical symptoms or flare-ups of UC. Some of the techniques, like cognitive behavioral therapy (a type of psychotherapy) and patient support groups, have been so successful that they have slowly become a part of mainstream treatment for IBD.

Vitamins and supplements: Many people with ulcerative colitis may not absorb enough of some vitamins or minerals from food because of their disease. In these cases, your doctor may suggest taking certain supplements. Still, its important to speak with your doctor before you decide to take any on your own. Many of these substances can be unsafe, particularly if you have UC and youre taking other medicines. Some people also take certain supplements in the belief that they help control UC symptoms. These might include:

Keep in mind that the FDA doesn't regulate supplements, so claims on packaging may not be accurate. Thats yet another reason why its important to talk to your doctor before you start taking any supplements for your UC.

SOURCES:

National Digestive Diseases Information Clearinghouse.

Crohn's & Colitis Foundation of America: Complementary Therapies, What is Complementary Medicine? "What are Crohn's & Colitis?" "Surgery for Crohn's Disease & Ulcerative Colitis."

FDA: "FDA approves Inflectra, a biosimilar to Remicade." FDA approves Amjevita, a biosimilar to Humira.

Gastroenterology and Hepatology: The Use of Complementary and Alternative Medicine in Patients With Inflammatory Bowel Disease.

NIH Office of Dietary Supplements: Omega-3 Fatty Acids.

Journal of Crohn's and Colitis: "Targeting S1P in Inflammatory Bowel Disease: New Avenues for Modulating Intestinal Leukocyte Migration."

National Genome Research Institute: "Antibody."

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Ulcerative Colitis Treatments and Surgery - WebMD