Treatment
The aims of treatment are to treat relapses and to maintain symptom remission.
In the majority of cases ulcerative colitis can be treated with medication. Corticosteroids in the form of suppositories or enemas are used to treat milder cases where the condition affects the rectum or lower bowel only. They may also be given orally to treat exacerbations.
Other drugs of the aminosalicylate family (sulphasalazine, 5-aminosalicylic acid, mesalazine) are given as suppositories, enemas and in tablet form to treat mild – moderate exacerbations. These drugs can also be prescribed on a long-term basis to keep the condition under control.
Immuno suppressant drugs such as azothiaprine and ciclosporin are used to treat more severe cases, or when other drugs are less effective. Severe exacerbations may need admission to hospital and intravenous corticosteroids.
In 20% of cases surgery may take place to remove part or the entire diseased colon. Emergency surgery may be required in cases of severe haemorrhage, perforation of the bowel or toxic mega colon. It may also be undertaken electively, if the disease proves to be resistant to drug treatment. If the entire colon is removed the person will be left with an ileostomy. Various types of restorative surgery can be undertaken to try to maintain continence including fashioning of pouches from the bowel.
People with ulcerative colitis are offered long-term follow up with colonoscopies because of the risk of developing cancer of the colon. The interval between colonoscopies is determined by the length of time the disease has been present.
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Amended April 2008
