Ulcerative Colitis Treatment Options

I often call ulcerative colitis a 'guess-and-check' disease because the treatment options vary so widely that it can take years to find one that works. Dozens of factors must be taken into consideration when determining a treatment regimen, and what works for one patient might make symptoms worse for another. When exploring the treatment options for ulcerative colitis, it is important to have a doctor's guidance.

Drug therapy is the most common treatment for ulcerative colitis sufferers, but there are many options underneath this one large umbrella. Anti-inflammatory drugs, for example, can be used to control the inflammation and irritation in the rectum, colon and other affected areas. This is frequently the first line of defense that physicians describe to control the disease, particularly in patients who have mild cases.

If anti-inflammatories alone don't work for ulcerative colitis, there are other treatment options concerning drug therapy. Corticosteroids are a step up in efficiency from anti-inflammatories, but they carry more side effects than the other drug and may produce serious cases of depression in some patients. Prednisone is one of the most popular corticosteroids, and is generally used to simply gain control of the disease before weaning back to anti-inflammatories alone.

In addition, immunosuppressives have been found to be very efficient in treating ulcerative colitis, especially in cases where the disease has achieved remission with other drugs, but requires additional assistance for symptom control. This type of drug suppresses the immune system by inhibiting the development of bone marrow, which in turn decreases inflammation in the rectum and colon. The problem with this type of drug therapy is that it can have averse side effects in patients with other diseases and disorders.

Consequently, patients taking immunosuppressives must have regularly scheduled visits the doctor for blood work and other evaluations. If the patient shows an averse reaction, administration is stopped immediately. In most cases, this treatment option takes three or four months to begin relieving ulcerative colitis symptoms, so it can be frustrating for the patient.

None of the above drugs was effective in my case of ulcerative colitis, so I was prescribed Remicade in February of 2006. This treatment option was only approved in late 2005, and works by neutralizing the tumor necrosis factor protein in your blood. I'm told that it might lose its potency over time---probably years, if ever---but it works well in decreasing inflammation and symptoms of the disease.

If drug therapy treatment options don't work for ulcerative colitis patients, the next step is usually surgery. This is reserved for patients with severe forms of the disease, and can be extremely painful. There are situations in which Laparascopic surgery, which is minimally invasive and produces few side effects, can work, but more invasive surgeries are frequently required.

For example, Ileal-anal pouch surgery involves removing the colon and rectum from the patient, and connecting the small intestine to the anus. This type of surgery doesn't require the ulcerative colitis patient to wear a bag, which is necessary in the far more invasive Proctocolectomy surgery. However, the patient may have watery stool several times per day because the colon is no longer there to absorb water content.