How is Ulcerative Colitis Treated?

The course of treatment for colitis depends upon the severity of the illness in an individual. Most patients can be treated with medication and remain in remission for long periods of time. Other patients experience severe enough symptoms that surgery may be required to remove the diseased parts of the intestine. There is no medication that can cure Ulcerative Colitis. The goals of treatment consist of improved quality of life, inducing and maintaining periods of remission, and minimizing the symptoms of the disease. Some of the medications used to treat colitis include:

5-ASA Compounds

These are anti-inflammatory medications including Asacol, Pentasa, and Rowasa Enemas. These medications are only effective if they come in direct contact with the inflammation in the tissue. 5-ASA Compounds are similar to aspirin and should be used with caution in patients who are known to have kidney disease or are at risk for kidney disease.

  

Corticosteroids

These drugs include prednisone, prednisolone, and hydrocortisone. They may also be used to treat inflammation but these drugs usually have undesired side effects with long-term use. Common side effects consist of water retention (mainly in the face), glaucoma, cataracts, diabetes, high blood pressure, muscle weakness, weight gain, increased body hair, insomnia, depression, and osteoporosis. Because these drugs have so many side effects they should be used for the shortest length of time possible. 

Immunomodulators

These are medications that are designed to weaken the body's immune system. Because inflammatory bowel disease is thought to be an autoimmune disease, meaning that a patient's immune system attacks it's own body, weakening the immune system is effective in reducing symptoms and inducing and maintaining remission. The two most common drugs in this class are Azathioprine (Imuran) and 6-Mercaptopurine (Purinethol). These drugs weaken the immune system by reducing a category of immune cells known as lymphocytes. Immunomodulators are used as a last resort, before surgery, because of the seriousness of side effects. Side effects may include inflammation of the liver (hepatitis), inflammation of the pancreas (pancreatitis), vulnerability to infections, and bone marrow toxicity.

  

Methotrexate

This drug is an immunomodulator and an anti-inflammatory. It is used when Azathioprine, 6-MP, and Corticosteroid drugs do not have any effect. It can be taken orally or administered by injection either under the skin or in a muscle. Injections are usually administered on a weekly basis. A major complication of Methotrexate is cirrhosis of the liver when medication is used for a prolonged period of time.