No two cases of ulcerative are exactly the same, so when treating ulcerative colitis, your healthcare team will focus on your individual symptoms. For mild pain and discomfort, inflammation, and deficiencies, your doctor may prescribe treatments such as antidiarrheals, anti-inflammatories and antispasmodics, as well as pain relievers such as Tylenol, and supplements such as iron. Some treatments are available over-the-counter, while others require a prescription.
When symptoms are moderate to severe, your doctor may prescribe biologics that target the immune system or immunosuppressant drugs to help reduce inflammation. When medications stop working, if cancer is suspected, or if symptoms are life-threatening, extensive treatment in a hospital setting or surgery will be required.
Anti-diarrheal medications for ulcerative colitis include Imodium A-D (loperamide) and Pepto Bismol (bismuth subsalicylate). Both can be obtained over-the-counter.
Anti-inflammatory medications for ulcerative colitis include corticosteroids, such as prednisone and budesonide, and 5-aminosalicylates such as sulfasalazine (Azulfidine), mesalamine (Asacol HD, Delzicol, others), balsalazide (Colazal) and olsalazine (Dipentum). These medications require a prescription.
Antispasmodic medications for ulcerative colitis include, but are not limited to Buscopan (Hyoscine butylbromide), Bentyl (Dicyclomine), and Mebeverine (Colofac, Duspamen and Duspatalin).
Biologics for ulcerative colitis include, but are not limited to Stelara, Entyvio, and Humira.
Immunosuppressant drugs for ulcerative colitis include Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan), Cyclosporine (Gengraf, Neoral, Sandimmune), and Tofacitinib (Xeljanz).
Surgery for ulcerative colitis (proctocolectomy) involves removing the entire colon and rectum. Depending on the type of proctocolectomy, you may or may not need an ostomy pouch, which is worn outside the body to collect waste.
For individuals that do not require surgery, certain lifestyle changes may help control ulcerative colitis symptoms and extend the time between flare-ups. Examples include:
- Avoiding non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.
- Eating five or six small meals a day.
- Eliminating alcohol, caffeine, and carbonated drinks from your diet.
- Increasing water intake.
- Limiting stress.
- Limiting dairy.
- Exercising daily.