Ulcerative Colitis Treatment

There is no known cure for ulcerative colitis. Healthcare providers treat the symptoms of UC with the overall goal of minimizing flares and improving quality of life.

Most healthcare providers recommend a combination¹⁸ of medications, diet changes, and, in some severe cases, surgery.

Ulcerative Colitis Medications

There are several types of medications that have proven effective in treating ulcerative colitis. The particular medication that works for you will depend on a number of factors, including the severity of your symptoms and the area of your GI tract that’s affected.

Some types of medication commonly prescribed to treat UC include¹⁹:

• 5-aminosalicylic acid (5-ASA): This medication, which is often used as the first line of UC treatment, may be taken as oral medications or rectally (as either enemas or suppositories). Examples of 5-ASAs include mesalamine (generic Asacol HD, Delzicol, others), olsalazine (generic Dipentum), and sulfasalazine (generic Azulfidine).

Which medication you’ll take, as well as how it’s administered, will depend on the area of your colon affected by UC.

• Immunomodulators: Immunomodulator drugs help to reduce inflammation by suppressing the immune response. Commonly prescribed immunomodulators include azathioprine (generic Azasan, Imuran), cyclosporine (generic Gengraf, Neoral), mercaptopurine (generic Purixan), and tofacitinib (generic Xeljanz).
• Biologics: Some types of biologics used to treat UC include adalimumab (generic Humira), golimumab (generic Simponi), infliximab (generic Remicade), and vedolizumab (generic Entyvio).
• Corticosteroids: These medications, which include prednisone (generic Prednisone Intensol, Deltasone) and budesonide (generic Uceris), are most commonly prescribed for moderate to severe cases of UC. Additionally, because of their side effects, corticosteroids aren’t usually taken long term.

Other medications may be necessary to help manage the signs and symptoms of ulcerative colitis. Loperamide (generic Imodium A-D), for example, can help improve severe diarrhea. Generally, however, speak with your healthcare provider before starting any new medications—ever over-the-counter ones—for your UC.

Your provider may prescribe the following medications for ulcerative colitis:

Ulcerative Colitis Diet

Ulcerative colitis is not caused by diet-related factors, however many people with UC find that certain foods can trigger symptoms. People with UC must retain a nutritionally balanced diet, as the associated symptom of diarrhea can cause a person’s body to absorb fewer nutrients.

Those with UC tend to avoid spicy and high-fiber foods, as those can be irritating to the digestive system. The following foods²⁰ are recommended for people experiencing a UC flare:

• Fruits that are low in fiber: Cantaloupe, bananas, melons, cooked fruits
• Lean proteins: White meat, soy, eggs, fish, lean pork, firm tofu
• Grains: Potato, sourdough bread, white pasta, white rice, oatmeal, gluten-free bread
• Cooked, non-cruciferous vegetables: Potatoes, squash, cucumbers, asparagus tips

As with any condition, it’s best to consult your healthcare provider or a specialist (such as a registered dietician) before making drastic changes to your diet.

Ulcerative colitis surgery

About 25–35% of people with ulcerative colitis undergo surgery²¹ to remove the most severely affected portions of their colon. This procedure is called a colectomy.

In order for a person to have a colectomy, they must be in good overall health. Surgery for ulcerative colitis may include either removing the entire colon and rectum (called a total colectomy, which necessitates the use of an external colostomy/waste bag) or removing the entire colon but preserving the use of the bowels (called a partial colectomy, which eliminates the need for an external colostomy bag).