Treatment for ulcerative colitis is different from one child to another. What helps one patient may not help another. Treatment for ulcerative colitis depends upon many things:
- Health of the child
- How much of the colon is inflamed
- Ability of the child to take certain medicines or undergo certain procedures
The goal of treatment is to:
- Control symptoms
- Put the disease into remission (making the disease inactive)
- Help keep the disease in remission
- Improve the quality of life
Some patients go into remission (the symptoms of ulcerative colitis go away). However, it is not uncommon for the symptoms to come back (a "flare").
Several different types of medicines may be used to help control the symptoms of ulcerative colitis. Each helps decrease the swelling in the lining of the colon.
Anti-inflammatory drugs (aminosalicylates or 5-ASA drugs) are usually used to treat mild to medium symptoms. Some examples are Asacol HD, Pentasa, Lialda, Apriso and Colazal.
Corticosteroids, such as prednisone, help to put a patient with medium to severe symptoms into remission. These drugs are not good to use for a long time because of side effects.
Drugs that suppress or quiet the immune system (immunomodulators) are used in medium to severe ulcerative colitis to help patients stay in remission. Some examples are Imuran (azathioprine), purinethol (6-MP) and methotrexate.
Antibiotics may also be used to treat bacteria in the small intestine that can keep the inflammation going. Some examples are Flagyl (metronidazole), Cipro (ciprofloxacin) and Rifaxamin.
Biologics are a newer drug approved by the US Food and Drug Administration for treating medium to severe ulcerative colitis that does not respond to the other medications. This medicine is given through a vein (intravenously) or as an injection.
Most patients with ulcerative colitis do not need surgery. When medicine does not work, about 20 percent to 30 percent of patients must have surgery. Ulcerative colitis is cured when the colon is removed.
The most common type of surgery is restorative proctocolectomy with ileal pouch – anal anastamosis. This is the removal of the entire colon, then creating a pouch to hold waste prior to having a bowel movement.
Patients can live normal and active lives after surgery.