Ulcerative colitis is a long-term condition that affects the large intestine, or colon. It can cause swelling, inflammation, and small sores on the colon’s lining.
Ulcerative colitis (UC) is an autoimmune condition, which means that the immune system works against its own cells and tissues.
Symptoms can include:
- loose or urgent bowel movements
- persistent diarrhea
- abdominal pain
- bloody stools
- a loss of appetite
- fatigue or extreme tiredness
UC tends to follow a relapsing-remitting path. This means that symptoms get worse for a while, then become less severe.
The condition affects everyone differently, and the best type of treatment depends on the severity of the disease. Below, learn about the range of options.
There is no cure for UC, but medications can help. Current guidelines recommend long-term treatments that change the way that the immune system works.
There are several options, and each can reduce the risk of a flare-up and lessen the severity of symptoms. They include:
- TNF-α antagonists, such as infliximab (Remicade) or adalimumab (Humira)
- anti-integrin agents, such as vedolizumab (Entyvio)
- Janus kinase inhibitors, such as tofacitinib (Xeljanz)
- interleukin 12/23 antagonists, such as ustekinumab (Stelara)
- immunomodulators, such as thiopurines and methotrexate
These drugs can have adverse effects, however. Speak to a doctor about the benefits and risks.
The doctor will take various factors under consideration, including other ongoing medications, and tailor a treatment plan.
Other drug options
Aminosalicylates, such as 5-aminosalicylates (5-ASAs), can help reduce inflammation and may be useful in treating UC symptoms.
- balsalazide (Giazo)
- mesalamine (Azacol)
- olsalazine (Dipentum)
- sulfasalazine (Azulfidine)
If 5-ASAs do not work, a doctor may prescribe corticosteroids to reduce inflammation. However, long-term use can lead to severe adverse effects, and doctors try to avoid this whenever possible.
Experts currently recommend focusing on long-term treatment to reduce the need for steroids.
Some people with UC require surgery. This usually resolves the condition by removing the colon.
Surgery may be the best option if the person:
- has colon cancer
- has precancerous cells in their colon
- has serious UC complications
- finds that medication does not improve their symptoms
There are two types of surgery for treating UC:
Proctocolectomy with ileostomy
A proctocolectomy involves removing the whole colon, including the rectum.
Doctors sometimes refer to an ileostomy as a stoma. It involves repositioning the end of the small intestine through an opening in the outside of the person’s stomach, just above their waistline.
The surgeon then connects an ostomy pouch, or stoma bag, to the opening. The contents of the small intestine collect in the bag, which is removable, rather than passing out through the anus. This is permanent.
Proctocolectomy with ileoanal reservoir
This likewise involves removing the colon and rectum. The surgeon then creates an ileoanal reservoir, which some call a J-pouch, at the end of the small intestine and connects it to the anus.
Waste then collects in the reservoir before passing through the anus. People who have this operation do not require a stoma.
Possible side effects of an ileoanal reservoir include:
Some people who have undergone the procedure develop pouchitis, which involves the lining of the ileoanal reservoir becoming irritated or inflamed. Doctors usually treat it with antibiotics.
Some people with UC find the following supplements and home care strategies effective.
While poor nutrition does not cause UC, it can have an impact on symptoms.
Certain foods and drinks can also be triggers, meaning that they cause UC symptoms to get worse. Triggers are different for everyone, and keeping a food diary can help a person identify theirs.
A doctor may recommend switching to a low-fiber diet while symptoms flare up. Suitable foods may include:
- refined grains, such as in white bread and cornflakes
- white rice or pasta
- cooked vegetables without the peels, seeds, or stalks
- lean meats and fish
For someone with UC, soft, bland foods may be easier to eat than spicy foods. It is still important to aim for a varied diet that includes all food groups.
People commonly refer to probiotics as “friendly” or “good” bacteria. They boost the levels of beneficial bacteria in the gut. A person may prefer probiotic supplements, yogurts, or drinks, for example.
There is a growing interest in using probiotics to treat or help ease the symptoms of UC. However, there are many types of probiotics, and it is still unclear which are most likely to help and how effective these might be.
Nevertheless, probiotics are likely safe to take, although they may cause mild side effects in some people, such as gas or bloating.
Some people with UC may benefit from taking certain vitamins. Anyone who takes steroids for UC for long periods, for example, may develop poor bone health, in which case taking calcium can be beneficial.
People with UC may also be at risk of developing anemia, so doctors may recommend iron supplements.
Typically, people use aloe vera to help wounds heal and relieve pain, but some people also believe that it can reduce inflammation internally.
Some people with mild to moderate UC, for example, report that drinking aloe vera juice helps their symptoms. However, there is no scientific evidence for this.
It is also worth noting that aloe vera can have a laxative effect when consumed.
UC is a long-term condition that affects the colon. It causes inflammation and ulcers, leading to symptoms such as diarrhea, abdominal pain, and fatigue.
Various medications and self-care strategies can help manage the condition, as can surgery. The best approach will depend on the severity of the condition.