What are the treatments for ulcerative colitis (cont'd)?
5-aminosalicylate medicines are commonly used to prevent flare-ups. A lower 'maintenance dose' than the dose used to treat a flare-up is usual. You can take one indefinitely to keep symptoms away. Most people have little trouble taking one of these medicines. Some people develop side-effects such as abdominal pains, feeling sick, headaches, or rashes. If one medicine causes side-effects, switching to an alternative may be fine as side-effects can differ between the different 5-aminosalicylate medicines.
If a flare-up develops whilst you are taking a 5-aminosalicylate medicine then the symptoms will usually quickly ease if the dose is increased, or if you switch to a short course of steroids.
Other medicines may be advised if a 5-aminosalicylate medicine does not work, or causes difficult side-effects. For example, azathioprine or 6-mercaptopurine are sometimes used.
Surgery
Unfortunately, not everyone with UC has their symptoms well controlled with medication. About 3 in 10 people with UC need surgery at some stage. The common operation is to remove the large intestine. There are different techniques used for this. It is helpful to discuss the pros and cons of the different operations with a surgeon. Removing the large intestine will usually cure symptoms of UC permanently.
Surgery is considered in the following situations.
- During a life-threatening flare-up. Removing the large intestine may be the only option if it swells greatly ('megacolon'), perforates, or bleeds uncontrollably.
- If UC is poorly controlled by medication. Some people remain in poor health with frequent flare-ups which do not settle properly. To remove the large intestine is a serious step, but for some people the operation is a relief after a long period of ill health.
- If cancer or 'pre-cancer' of the large intestine develops.
- A special diet is not usually needed. A normal, healthy, well balanced diet is usually advised. If you have UC just in the rectum (proctitis), a high fibre diet may help to avoid constipation.
- You may be advised to take iron tablets if you develop anaemia.
- You may need painkillers and/or anti-diarrhoeal medicines when symptoms flare-up.
Newer medicines
Treatment for UC is an evolving field. Various new medicines are under investigation and are likely to change the treatment strategies and options over the next ten years or so.
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vicky knowles, over 2 years
i first got colitus in 1993. i was on steroids and asacol i was ill on and off for 3 years when i eventually ended up in hospital on a drip. then after leaving hospital we went on holiday to spain where i started smoking again after not smoking for ten years i had heard somewhere that smoking helped with colitus and seeing as i hadnt got a life and depressed i thought it worth a try. within 7 days i was better so a few months later stopped smoking and found that with in10 days my colitus was back again. i have tried many many times to stop smoking but my colitus always always comes back. i even tried nicotine patches but they were no good i still got my colitus back. now i have a cavalier spanial with colitus. she is on steroids but she is so ill i cant see her pulling through. can dogs have asacol. i have been on asacol since 93, dont know if they are working or its the smoking thats keeping it at bay. my dog is on allergenic food for weeks now but she is still very poorly so i am now just giving her rice and salmon as her flatulence on the dog food could kill an army.
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