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Ulcerative Colitis Treatment – Medical

Medical Treatments for Ulcerative Colitis

People with Ulcerative Colitis can go into remission or continue to control their symptoms using standard medical treatments, alternative treatments or a combination of both.

Medical treatments do NOT cure Ulcerative Colitis. They can put you into remission by alleviating the symptoms and giving the colon a rest. Some people use the word remission to mean lack of symptoms while taking medications. Some people use the word remission to mean lack of symptoms when taking no medications.

If one drug does not work for you, the doctor will prescribe another one or try a combination of drugs. Here is a list of medications used to treat Ulcerative Colitis 

Serious Reactions to Medications

Please remember you are ultimately responsible for your own health. Look up any and all drugs you are going to take on and click on the advanced link to read about the side effects of the drug which is found towards the end of the pages. My son almost died from taking Asacol, an non-steroidal anti-inflamatory (NSAID). He is allergic to salicylate which is the base of all the anti-inflammatory drugs used to treat Ulcerative Colitis and as his diarrhea increased the GI kept increasing the Asacol. He ended up with pancreatitis (5% of patients will develop it from the drug) and interstitial nephritis (7% patients will develop it from the drug). If you are allergic to aspirin (which is a salicylate) don’t take NSAIDS.

If you take over the counter drugs always check with your GI.

Some people have a lot of pain. Others not so much or none at all. Every body is different.

DO NOT TAKE ASPIRIN– unless you are instructed to do so by your Physician – aspirin can cause digestive tract bleeding.

Ibuprofen – is aspirin based. If you are allergic to aspirin or salicylate do not take this. It supposedly is not as hard on the digestive tract but can also cause bleeding in some cases.

Acetaminophen/Tylenol – If your pain is mild, Tylenol is ok to take but check with your doctor first. Tylenol can be very hard on the liver and if you are taking other medications you could end up with a severe problem. Don’t take any more than the recommended dosage per day.

Narcotics – If your pain is severe the doctor may give you a narcotic drug like Vicodin. Vicodin can actually help with a flare. It not only helps the pain but also calms the spasms in the colon. One has to be careful with narcotics. Not only can the possibility of addiction become an issue, constipation can set in. Though that sounds wonderful if you have been having diarrhea, the colon muscle can become dilated/paralyzed and stop working altogether. This is something called toxic mega colon and is very serious needing immediate hospitalization. Not all constipation will turn into toxic mega colon. Narcotics are strictly monitored by government regulations in the US and your doctor will only allow you to be on them for short periods of time. 


NSAIDS/Non-Steroidal Anti-inflammatory Drugs — If you not allergic to asprin and salicylates, your GI should try these first. There are increasing numbers of these drugs available. They can be given by pill or enema (solution that is squirted up the anus). There are people who have found that “treating both ends” works for them. They use a combination of oral and enema medications. The generic and trade names of some of these drugs are sulfasalazine (Azulfidine), olsalazine (Dipentum), mesalamine (Asacol, ,Lialda, Pentasa and Rowasa) and balsalazide (Colazal). Please look them up on

Cortisone, Steroids, Prednisone — These powerful drugs usually provide highly effective results. They also have some terrible side effects. A high dose is often used initially to bring the disorder under control. Then the drug is tapered to low, maintenance doses, even to a dose every other day. These medications are given by pill, enema or intravenously during an acute attack. In time, the physician will usually try to discontinue these drugs because of potential long-term, adverse side effects.


Anti-Spasmatics – Some doctors will prescribe medications that will calm the muscle spasms in colon as a way of relieving the pain. You should be monitored while on these as toxic mega colon can develop.

Anti-Diarrheals These you can buy over the counter, like IMODIUM®. They stop the spasms in the colon. However, people with Ulcerative Colitis need to be careful because they do cause constipation and overuse can cause toxic mega colon


Immune System Suppressors – An overactive immune system may be causing your Ulcerative Colitis. Certain drugs such as inflixamab (Remicade), azathioprine (Imuran), 6-MP (Purinethol), cyclosporine (Neoral, Sandimmune), and methotrexate (Rheumatrex) suppress the immune system and can be effective.  Some of them are used in the treatment of certain cancers. They suppress your immune system and leave you body vulnerable. Please look these up on and/or talk to your doctor and pharmacist. These medications should be used when all other medications have failed. Some of the infections that can occur while taking these drugs can be fatal. Your doctor should monitor and you should report to him immediately if you start running a fever. This treatment for severe cases of Ulcerative Colitis can work well and put you in remission so you can function so be aware of all your options.


Fecal Microbiota Transplantation (Fecal TransplantThis is a fairly new treatment where healthy human stool is placed in the affected colon.

Ulcerative Colitis SURGERY

UC Surgery — For patients with longstanding disease that is impossible to control with medicine, surgery can be a welcomed option. Please read all you can about the types of surgeries that are available. Some people are very happy they had it done while others have ended up with complications. Surgery is always serious and must be considered only after all other types of treatments have been exhausted. In the past a permanent bag, or ileostomy, was required for this surgery. Advances in surgery now can avoid this procedure. The colon is removed and a pouch or reservoir is created from the small intestine. It is a good idea to speak with at least three different GI’s before undergoing any kind of surgery.

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