Ulcerative colitis affects each person differently, and people respond to treatments differently as well. Mayo doctors design regimens to meet each person's unique needs. Those needs often change over time. As your body responds to treatment, the most effective therapeutic approach is likely to change, too.
People who have ulcerative colitis often develop inflammation outside the colon — in their joints, eyes, skin or lungs. They may have other health problems, too, such as diabetes. Mayo Clinic's integrated approach to patient care ensures that any additional medical conditions are evaluated and treated quickly by Mayo specialists who work closely with your primary doctor.
Mayo Clinic doctors involve you in all treatment decisions to help find the approach that provides the greatest benefit with the fewest side effects. Your doctor will thoroughly discuss any concerns that you may have about a particular treatment so that you can make the most informed decision possible.
Sometimes very mild ulcerative colitis symptoms can be controlled with diet and lifestyle changes. But most people need medications to relieve their symptoms. The traditional approach is to start treatment with the safest drugs and then switch to stronger medications if first line drugs fail to relieve your symptoms.
Surgery might be recommended if medication doesn't relieve inflammation or your colon develops precancerous changes. About 25 to 30 percent of ulcerative colitis patients eventually need surgery. Ulcerative colitis surgery usually involves removing the colon and rectum (proctocolectomy).
- Ileoanal anastomosis surgery (J-pouch). Ileoanal anastomosis is the most common surgery for ulcerative colitis. Its primary advantage is that you can eliminate waste normally afterward. In many cases, ileoanal anastomosis can be performed laparoscopically.
- Proctocolectomy with ileostomy. This procedure also involves removing the colon and rectum. An opening (stoma) is created on the outside of your body, usually in the lower abdomen, and you eliminate waste through the stoma into a small bag. Possible complications include infection and problems with the stoma. Most people who have this surgery, which can be performed laparoscopically, experience improved quality of life.
Treatment of children
By the time they are referred to Mayo Clinic, many young people with ulcerative colitis have been prescribed steroids for their disease. Because long-term steroid use can have harmful effects on children, Mayo specialists often choose to use other drugs to reduce the need for steroids.
Ulcerative colitis often takes an even greater physical and emotional toll on young people, slowing their growth and delaying sexual maturation. At Mayo, young people and their families work closely with a psychologist who can help them navigate the day-to-day difficulties of living with ulcerative colitis.
Oct. 10, 2012
- Ulcerative colitis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/. Accessed July 1, 2011.
- About ulcerative colitis and proctitis. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/livingwithuc52010.pdf. Accessed July 1, 2011.
- Ulcerative colitis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018c.html. Accessed July 1, 2011.
- Shale M, et al. Isotretinoin and intestinal inflammation: What gastroenterologists need to know. Gut. 2009;58:737.
- Burakoff R, et al. Inflammatory bowel disease. In: Greenberger NJ, et al. Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. New York, N.Y.: The McGraw Hill Medical Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=6200149. Accessed June 20, 2011.
- Peppercorn MA, et al. Medical management of ulcerative colitis. http://www.uptodate.com/home/index.html. Accessed June 30, 2011.
- Ulcerative colitis practice guidelines in adults. Bethesda, Md.: American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/UlcerativeColitis.pdf. Accessed June 20, 2011.
- Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
- IBD and pregnancy: What you need to know. Crohn's and Colitis Foundation of America. http://www.ccfa.org/about/news/pregnancy. Accessed July 2, 2011.
- Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
- Fact sheet: Complementary and alternative medicine. Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/FactSheets/CAM.pdf. Accessed July 1, 2011.
- Taylor RA, et al. Curcumin for inflammatory bowel disease: A review of human studies. Alternative Medicine Review. 2011;16:152.
- Picco MF (expert review). Mayo Clinic, Jacksonville, Fla. July 11, 2011.
- Colorectal cancer screening guidelines. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/colorectal/basic_info/screening/guidelines.htm. Accessed July 12, 2011.
- Reddy D, et al. Possible association between isotretinoin and inflammatory bowel disease. American Journal of Gastroenterology. 2006;101:1569.
- Crockett SD, et al. A causal association between isotretinoin and inflammatory bowel disease has yet to be established. American Journal of Gastroenterology. 2009;104:2387.
- Crockett SD, et al. Isotretinoin use and the risk of inflammatory bowel disease: A case-control study. American Journal of Gastroenterology. 2010;105:1986.
- Bernstein CN, et al. Isotretinoin is not associated with inflammatory bowel disease: A population-based case-control study. American Journal of Gastroenterology. 2009;104:2744.
- Margolis DJ, et al. Potential association between the oral tetracycline class of antimicrobials used to treat acne and inflammatory bowel disease. American Journal of Gastroenterology. 2010;105:2610.
- Loftus EV (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2011.
You Are ... The Campaign for Mayo Clinic
Mayo Clinic is a not-for-profit organization. Make a difference today.