There are several medications that can help to improve ulcerative colitis (UC) symptoms, or cause them to go into remission. Surgical removal of the colon and rectum is the only cure for UC, however.

Your doctor will choose a UC medication for you based on disease severity and your ability to tolerate specific treatments. These are the most commonly prescribed drugs for treating this condition:

Aminosalicylates

  • Usually the first treatment for people with mild to moderate UC
  • Also given first when UC symptoms return after remission
  • Helps to control intestinal inflammation

Corticosteroids

  • Man-made versions of cortisol, a naturally occurring human hormone
  • Used to treat more severe UC symptoms and when aminosalicylates do not work
  • Helps to reduce intestinal inflammation
  • Recommended only for short-term use (2-3 months) due to potentially harsh side effects; usually stopped as soon as inflammation is controlled

Immunomodulators

  • May be used when aminosalicylates do not work
  • Suppresses the immune system to help reduce intestinal inflammation
  • Slow-acting: May need to be taken for 3-6 months before starting to work
  • Associated with a high risk of complications

Anti-tumor Necrosis Factor (anti-TNF) Agents

  • Used to treat UC when other medications do not work or have intolerable side effects
  • Targets and neutralizes TNF protein, which causes intestinal-tract inflammation
  • Given intravenously
  • Should be used with an immunomodulator to avoid allergic reactions
  • Carries a high risk of toxicity and infection, notably tuberculosis

Additional medications may be prescribed or recommended as needed to:

  • Stop infection
  • Control diarrhea
  • Relieve pain
  • Reduce emotional stress

Hospital Care for Ulcerative Colitis

People with UC sometimes need to be hospitalized, particularly when there is:

  • The need to stop severe bleeding from an intestinal ulcer
  • The need to treat severe, dehydrating diarrhea and replenish body fluids
  • A tear in the colon that requires surgery to repair
  • Concern that UC medication is no longer effective

The care a person with UC receives in the hospital may include:

  • Intravenous fluids to treat diarrhea and dehydration
  • Tube feeding
  • A special diet
  • Hospital-administered medications

Surgery for Ulcerative Colitis

After a period of treatment with medications, 10-40 percent of people with UC may need surgery to remove the rectum and part or all of the colon, followed by surgery to restore or restructure bowel movement capability, if:

  • Medication therapy no longer works.
  • Side effects become too severe to be tolerated.

Other reasons for surgical treatment of UC may include:

  • Severe illness
  • Cancer risk
  • Massive bleeding
  • Colon rupture

As with any illness serious enough to require a doctor’s care, it is important to follow your UC treatment program exactly as your doctor has instructed—including during remissions. Keep in mind, too, that although your UC may not be life-threatening, complications that treatment may help prevent, such as liver disease or severe bleeding, can be.