What are the treatments for ulcerative colitis?
Treatment of ulcerative colitis depends on the location and severity of a patient's disease, the presence of complications and the patient's response to previous medications. The major goal of treatment is remission: quieting inflammation and relieving symptoms. Medical therapy can usually control symptoms, but surgery may be required when medical therapy fails or if signs of colon cancer develop. Ulcerative colitis is cured by removing the colon.
Initial treatment of ulcerative colitis is medical, using antibiotics and anti-inflammatory medications (drugs such as Alzulfidine, Prednisone, etc.). These are usually necessary on a long-term basis. Prednisone has significant side effects, and, therefore, it is usually used for short periods. "Flare-ups" of the disease can often be treated by increasing the dosage of medications or adding new medications, such as 6-Mercaptopurine. Hospitalization may be necessary to put the bowel to rest. The medicines that commonly are tried first are a group of anti-inflammatory medicines called aminosalicylates.
These medicines are chemically related to aspirin, and they suppress inflammation in the gut and in joints. They are given either by mouth or by rectum, as an enema. Some medicines in this group include sulfasalazine (Azulfidine), mesalamine (Asacol, Pentasa, Rowasa) and olsalazine (Dipentum). Other, more powerful anti-inflammatory medicines are helpful, but they suppress the immune system, which causes an increased risk of infections. For this reason, they are used less often for long-term treatment. These medicines include prednisone (sold under several brand names), methylprednisolone (Medrol), budesonide (Entocort), azathioprine (Imuran), mercaptopurine (Purinethol) and cyclosporine (Neoral, Sandimmune).
Depending on the degree of blood loss, a patient with ulcerative colitis may require blood transfusions and fluid replacement through a needle in the vein (intravenous or IV). Medications that can slow diarrhea must be used with great care, because they may actually cause the development of toxic megacolon.
A patient with toxic megacolon requires close monitoring and care in the hospital. He or she will usually be given steroid medications through an IV, and may be put on antibiotics. If these measures do not improve the situation, the patient will have to undergo surgery to remove the colon. This is done because the risk of death after perforation of toxic megacolon is greater than 50%.
Similarly, a patient with proven cancer of the colon, or even a patient who shows certain signs thought to indicate a precancerous condition, will need his or her colon removed. Removal of the colon is called a colectomy. When a colectomy is performed, a piece of the small intestine (ileum) is pulled through an opening in the abdomen. This bit of intestine is fashioned surgically to allow a special bag to be placed over it, in order to catch the body's waste (feces) which no longer can be passed through the large intestine and out of the anus. This opening, which will remain for the duration of the patient's life, is called an ileostomy.
Surgery is used in people who have severe symptoms that are not controlled by medicines, who have unacceptable side effects from medicines, or who have a very high risk of colon cancer because of extensive inflammation in the whole colon. One of several surgeries may be used to treat ulcerative colitis, depending on the amount of colon that is affected. Either part of the colon or the entire colon can be removed. After some surgeries, bowel contents will have to leave the body through an opening called a stoma in the abdominal wall. The stoma replaces the function of the rectum, and may be connected to a drainage bag. It may be used temporarily or permanently. Newer surgical techniques allow many patients to keep the layer of the rectum that contains its muscles, even though the lining of the rectum needs to be removed. This type of surgery (called ileoanal anastomosis, or pull-through surgery) has a cosmetic advantage, and it allows bowel movements to pass through the rectum and to be near normal, except that bowel movements are more frequent (usually five to six times per day) and contain more liquid.
More information on inflammatory bowel diseases (ulcerative colitis, Crohn's disease)
What are the inflammatory bowel diseases? - Inflammatory bowel disease (IBD) is a chronic disorder that causes an inflamed and swollen digestive tract or intestinal wall.
What causes inflammatory bowel diseases? - The cause of inflammatory bowel disease is not known. Chronic inflammation present in the intestines of persons with both forms of IBD damages the bowel.
What are the symptoms of inflammatory bowel diseases? - Symptoms of inflammatory bowel diseases can include chronic diarrhea, abdominal cramps or pain, fever, and blood or mucus in the stool.
How is inflammatory bowel disease diagnosed? - To make a diagnosis of inflammatory bowel disease, a doctor must first exclude other possible causes of inflammation.
What're the treatments for inflammatory bowel disease? - Inflammatory bowel disease is treated with medication, exercise, and sometimes, surgery. Treatments for IBD are directed against the inflammation in the bowel.
What're the medications for inflammatory bowel disease? - Medications for inflammatory bowel disease include sulfasalazine, corticosteroids, immunosuppressives, and nonsteroidal anti-inflammatory drugs (NSAIDs).
What is Crohn's disease? - Crohn's Disease is a chronic illness that causes irritation in the digestive tract. Crohn's disease occurs in the last portion of intestine (ileum).
What types of Crohn's disease are there? - There are five subtypes of Crohn's disease, distinguished by the gastrointestinal area in which the disease occurs.
What causes Crohn's disease? - The cause of Crohn's disease is unknown. There is now evidence of a genetic link as Crohn's frequently shows up in a family group.
What are the symptoms of Crohn's disease? - The symptoms of Crohn's disease include abdominal pain, diarrhea, fever, loss of appetite and weight loss.
What are the complications of Crohn's disease? - Common complications of Crohn's disease include the development of an intestinal obstruction, pus-filled pockets of infection, and abnormal connecting channels.
How is Crohn's disease diagnosed? - The diagnosis of Crohn's disease is suspected in patients with fever, abdominal pain and tenderness, diarrhea with or without bleeding, and anal diseases.
What're the treatments for Crohn's disease? - Treatment for Crohn's disease is mainly symptomatic. Medications are very effective at improving the symptoms of Crohn's disease.
What medications cure Crohn's disease? - Medications for Crohn's disease sulfasalazine, Asacol, Pentasa and Dipentum. Mesalamine is useful both to achieve and maintain remission.
What's the surgery for Crohn's disease treatment? - Surgery to remove part of the intestine can help Crohn's disease but cannot cure it. The most used operation in Crohn disease is removing the diseased part of the intestine.
What Crohn's disease diet is suggested? - Diet may have to be restricted based on symptoms or complications of Crohn's disease. No particular food has ever been implicated in causing Crohn's disease.
Crohn's disease in children - Crohn's disease is most often diagnosed in young adulthood. Children facing Crohn's disease have significant self-image issues to deal with.
Crohn's disease and pregnancy women - Women with Crohn's disease who are considering having children can be comforted to know that the vast majority of such pregnancies will result in normal children.
What is ulcerative colitis? - Ulcerative colitis is an inflammatory disease of the bowel, that usually affects the distal end of the large intestine and rectum.
What types of ulcerative colitis are there? - Doctors categorize ulcerative colitis by the amount of colon involved. Variability of symptoms reflects differences in the extent of disease and the intensity of inflammation.
What causes ulcerative colitis? - The cause of ulcerative colitis is not known, but heredity and an overactive immune response in the intestine may be contributing factors.
What are the symptoms of ulcerative colitis? - The symptoms vary according to the extent of the disease. The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea.
What are the complications of ulcerative colitis? - Bleeding, the most common complication of ulcerative colitis, often causes iron deficiency anemia.
How is ulcerative colitis diagnosed? - Diagnosis of ulcerative colitis is suspected based on the symptoms that a patient is experiencing. The most important method of diagnosis is endoscopy.
What are the treatments for ulcerative colitis? - Treatment of ulcerative colitis depends on the location and severity of a patient's disease, the presence of complications.
What ulcerative colitis medications are available? - Medications for ulcerative colitis include 5-ASA Compounds, anticholinergic drugs, steroids, and immunosuppressive drugs.
What surgery treats ulcerative colitis? - Surgery for ulcerative colitis involves removal of the entire colon, regardless of whether all or only a portion of the colon is diseased.
Collagenous colitis and lymphocytic colitis - Collagenous colitis and lymphocytic colitis are chronic diseases in which certain kinds of white blood cells infiltrate the lining of the large intestine.