The goal in treating ulcerative colitis is to reduce the inflammation, hopefully leading to remission. The two leading treatment options are medication and surgery.
Approximately 70 percent of patients respond well to medication and go into remission. For those who did not respond well to medication, surgery is an option.
Treatment options for Ulcerative Colitis include:
The most common medication option is anti-inflammatory drugs. These can be used orally or topically to reduce inflammation of the colon and rectum.
Treating ulcerative colitis is a highly individualized process. At Johns Hopkins, we tailor your treatment to your specific needs and alter the medication as necessary. Your specific medication regimen will depend largely on the severity of your condition.
If you did not respond to a medication regimen or you developed complications of colitis, you may be a candidate for surgery to treat ulcerative colitis.
Colectomy (removing part or the entire colon) may be used in children with ulcerative colitis who experienced growth retardation. In all patients, elective colectomy can be a cure for ulcerative colitis. Almost always, the procedure is a total colectomy, meaning the entire colon is removed.
Surgical procedures include:
Total proctocolectomy with Brooke ileostomy. Removal of your entire colon and rectum. Your doctor will perform an ileostomy, which brings out your small intestine through the abdominal wall. Waste collects in an ileostomy bag. An ileostomy can be temporary or permanent.
Total proctocolectomy with intra-abdominal Koch pouch. This is a similar procedure to the one above, except that the pouch to collect waste is internal. You use a catheter to remove the contents.
Restorative proctocolectomy with ileal pouch-anal anastomosis. Removal of the entire colon and most of or the entire rectum. A new rectum is created from the small bowel.
Surgical options for the treatment of ulcerative colitis; A: proctocolectomy; B: Brooke ileostomy; C: Koch pouch ileostomy; D: restorative proctocolectomy. (Click to Enlarge)