There is no cure for ulcerative colitis (UC), but various treatments can help people manage their symptoms. These treatments include biologics, biosimilars, janus kinase (JAK) inhibitors, corticosteroids, and surgery.
There are several ways a person can treat the symptoms of the condition. This article looks at some of the treatment options for people living with UC.
Symptoms of UC can vary, and around half of the people with the condition experience only mild symptoms.
Common digestive symptoms of UC include:
- the urge to have a bowel movement even when the bowel is empty
- loose bowel movements
- bloody stools
- abdominal cramps
- abdominal pain
A person can often experience symptoms during UC flares. These are exacerbations in symptoms that occur between periods of remission, when the person experiences very few symptoms or none at all.
UC may also affect a person’s quality of life and general health, for example, by causing:
Available UC treatments can help a person regulate their immune system to reduce symptoms.
Treatments vary and can include medications, alterations to diet and nutrition, and, in some cases, surgery to repair or remove parts of the colon.
Below are some common treatment options for people with UC.
Biologics are medications that come from living cells. Doctors often refer to this medication as targeted therapy, because these drugs target cells and proteins in the immune system that are responsible for UC.
Biologic medications attack the cells to reduce their immune response. This helps alleviate UC symptoms, as it prevents the immune system from being overactive and mistakenly attacking the body’s own cells.
Doctors often prescribe biologics to people with
Common biologic therapies include:
- tumor necrosis factor-alpha antagonists, such as infliximab (Remicade) and adalimumab (Humira)
- interleukin-12/23 antagonists,
such asustekinumab (Stelara)
People take biologics via an injection or IV infusion. IV infusion involves administering a medication or another substance into a vein and directly into the bloodstream.
Biosimilars are a newer treatment for UC. They resemble biologics and use natural proteins to target the immune system.
Biosimilars use copies of antibodies to control a person’s immune response. They can help prevent the inflammation that UC causes, which can reduce the symptoms of the condition.
Healthcare professionals can use biosimilars to treat both UC and Crohn’s disease.
People take biosimilars via an injection or IV infusion.
Another new treatment for UC is the use of JAK inhibitors. Healthcare professionals can use these drugs to treat a number of inflammatory conditions, including:
JAK inhibitors are small molecule compounds that break down in the gastrointestinal (GI) tract after a person ingests them. Once these compounds break down, the bloodstream absorbs them through the intestines.
Once in a person’s bloodstream, the compounds work directly on the immune system.
The molecules work by attaching themselves to receptors on immune cells to block messaging pathways. This can reduce a person’s immune response, which can ease the symptoms of UC.
Medical professionals may also use corticosteroids to treat UC. These drugs lower the activity of the immune system. This in turn helps reduce inflammation in the colon and alleviate the symptoms of UC.
A person can take corticosteroids:
Healthcare professionals often use these drugs as a short-term treatment for UC flare-ups. This is because they act quickly and can work within a few days.
It is of note, however, that corticosteroids are not a long-term treatment option for people with UC. This is due to the various side effects these medications can cause.
Possible side effects of long-term corticosteroid treatment
- an increased risk of infections
- undesirable weight gain
- high blood pressure
- thinned skin
- mood changes and depression
Aminosalicylates are compounds that contain 5-aminosalicylic acid. These drugs can control the symptoms of IBD by reducing inflammation in the GI tract.
Healthcare professionals often use aminosalicylates to treat mild to moderate UC.
Along with corticosteroids, aminosalicylates are often the first-line treatment for UC. People can take these drugs orally, via a suppository, or via an enema.
According to the Crohn’s & Colitis Foundation (CCF), these drugs are very safe, and people tend to tolerate them well. However, some common side effects include:
In some cases, a person with UC may require surgery. This is often a suitable option for individuals whose bodies no longer respond to medication.
Some people choose to undergo surgery to improve their quality of life. In some rare cases, a person may become dangerously ill and need emergency surgery.
Common UC surgery includes removing the entire colon during a colectomy or removing the colon and the rectum in a proctocolectomy.
These surgeries can prevent the symptoms of UC from arising, as the person no longer has a colon that can become inflamed.
After these surgeries, some people may require what doctors call an ileal pouch anal-anastomosis. Surgeons will pull part of the small bowel down and connect it to the anus to replicate some function of the colon.
Some individuals may need a temporary ostomy bag before the final anastomosis. An ostomy bag sits on the outside of a person’s body near their stomach. The bag collects waste from the body through a hole called a stoma.
Colectomies can cause various side effects,
- fecal incontinence
- small bowel obstruction
Adjustments to diet and nutrition
It is important that a person with UC eat a balanced diet. This is because proper nutrition can affect a person’s UC symptoms and their general well-being.
The CCF offers a variety of dietary tips that a person with UC can follow to help manage their symptoms and achieve balanced nutrition. These tips include:
- eating four–six small meals per day
- remaining hydrated by drinking plenty of water and other fluids
- drinking slowly and avoiding using a straw, to prevent ingesting air
- preparing meals in advance
- keeping the kitchen well stocked with foods they can easily tolerate
- using a food journal to keep track of what foods they eat and how these foods affect their symptoms
During a flare-up, a person with UC may wish to avoid certain foods that can trigger UC symptoms, such as bloating, cramping, and diarrhea.
These foods include:
- Insoluble fiber foods: These foods can be hard to digest and include fruits with skin and seeds, raw vegetables, such as broccoli or cauliflower, whole nuts, and whole grains.
- Lactose: This includes dairy products, such as milk, cream, and cheese.
- Nonabsorbable sugars: These sugars are often in sugar-free gum, candy, ice cream, and some fruits and fruit juices, such as pear, peach, and prune.
- Sugary foods: These include pastries, candy, and juices.
- High fat foods: These include butter, coconut, margarine, and cream, as well as fried, fatty, or greasy foods.
- Alcohol: This includes beer, wine, and liquor.
- Caffeine: Examples include some sodas, coffee, and teas.
- Spicy food: People should avoid eating spicy food during a flare-up, as it can worsen symptoms.
When a person is in remission, they may also want to adjust their diet to help them remain healthy and hydrated. This means they may wish to consider eating some of the following:
- Fiber-rich foods: These include beans, nuts, whole grains, oat bran, and barley. If an individual has an ostomy or an intestinal narrowing, they may wish to avoid these high fiber foods.
- High protein foods: These include lean meats, fish, eggs, nuts, and tofu.
- Fruit and vegetables: A person should ensure they are eating as much fruit and vegetables as possible.
- Probiotics: Probiotics can help a person with UC improve their quality of life. These foods include yogurt, kimchi, miso, and tempeh.
- Foods high in calcium: These include yogurt, collard greens, and milk. If an individual has lactose intolerance, they may wish to consider lactose-free dairy products.
UC is a lifelong chronic condition. A person with UC will often experience flare-ups between periods of remission.
The lifespan for people with UC is the same as for people without it.
Mortality is increased in individuals who develop certain complications, such as:
- surgical complications
Ischemia is the name for restricted blood flow and oxygen supply to certain parts of the body. According to experts, ischemia is the most common cause of death in people with UC.
Below, we answer some questions people commonly ask about UC treatment.
UC is a form of IBD that causes inflammation and ulcers to form in the colon. Symptoms of UC include an increased urge to have bowel movements, loose bowel movements, bloody stools, abdominal pain and cramps, and diarrhea.
Symptoms of UC often come during flare-ups, which happen between periods of remission. During remission, a person can experience very few symptoms or none at all.
UC is a lifelong condition, and there is currently no cure. However, there are various treatment options that can help reduce symptoms and lengthen remission periods. These treatments include biologics, biosimilars, JAK inhibitors, corticosteroids, aminosalicylates, and surgery.
The mortality rate for people with UC is the same as for individuals without the condition.
What is the latest treatment for UC?
What is the safest treatment for UC?
What is the main cause of UC?
While a definitive cause for UC is not clear, the condition
What foods heal UC?
No diet can cure UC. However, according to the CCF, a person living with UC may want to eat low fiber fruit or cooked fruit and vegetables.
In addition, they should eat lean meat and plant-based proteins, as well as white bread and pasta, potatoes, or oatmeal. This is because these foods are less likely to aggravate symptoms.
Is there a cure for UC?
The only cure for UC is a proctocolectomy, which is the