An issue a patient diagnosed with ulcerative colitis must quickly tackle is exploring treatment alternatives.  This might include seeing both a gastroenterologist and a surgeon.  Fortunately, the list of ulcerative colitis treatment options continues to grow.

Overview of Ulcerative Colitis

Ulcerative colitis (UC) and Crohn’s disease are the two primary types of inflammatory bowel disease (IBD).  UC is a chronic disorder affecting around 700,000 Americans, says the Crohn’s & Colitis Foundation of America (CCFA).

UC is an inflammation of the lining of the colon (large intestine).  Managing this type of IBD is a difficult for many patients, who must cope with symptoms like diarrhea, pain, rectal bleeding, and overpowering fatigue.  Sometimes months or even years pass before the illness flares again.

Although researchers have failed to pinpoint the cause of this type of IBD, about 20 percent of patients have a close relative with the same disorder.  Recent research leans toward a flaw in the natural response of the body’s immune system.  While medical treatments and dietary changes can help manage the disease, the only cure is removal of the colon.

Medical Treatments

According to the Mayo Clinic, these types of drugs are used to manage UC:

• Anti-inflammatories include aminosalicylates like Asacol, Rowasa, and Azulfidine, available as oral medications, suppositories, and enemas.  Doctors reserve corticosteroids such as prednisone for moderate to severe cases that have not responded to other drugs.

• Immunosuppressants can be combined with steroids to cause remission.  Among those frequently used are azathioprine, mercaptopurine, and cyclosporine.

• Biologics are also called tumor necrosis factor (TNF)-alpha inhibitors.  The most common are Remicade and Humira.  They neutralize a protein the immune system produces and are limited to patients with moderate to severe disease when other treatments do not work or cannot be tolerated.

• Additional medications might include antibiotics, antidiarrheals, iron supplements, and pain relievers.

Some of these medications can cause serious side effects.  A physician can help each patient weigh risks against benefits.

Surgical Options

Up to a third of UC patients might need surgery due to complications or unsuccessful medical therapy, CCFA reports.  According to Cedars-Sinai®, surgeons perform several types of procedures after removal of the colon and rectum:

• A standard ileostomy.  Waste exits the body through an opening in the abdomen and collects in an external pouch the patient periodically empties.

• A continent ileostomy.  It avoids the use of an external pouch.  Waste empties into an internal pouch, which a patient drains by inserting a tube into a small abdominal opening.

• A pull-through procedure.  It allows an individual to experience normal bowel movements, since a portion of the rectum remains.

A more recent development is the Barnett Continent Intestinal Reservoir (BCIR).  This internal pouch features an improved design over those associated with earlier continent ileostomies.  For many patients dissatisfied with earlier surgeries, the BCIR offers convenience and improved quality of life.