Can my Ulcerative Colitis be healed?
Unfortunately, so far there is no cure for ulcerative colitis except for the surgical removal of the colon, which will be recommended only in case of very severe disease with serious complications. The aim of treatment is to stop acute episodes when they occur and to reduce the risk of recurrent relapses.

What medical treatment is available?
Although surgery may become necessary to treat complications or refractory disease, drug therapy is the cornerstone of disease management.

For mild to moderate disease, mesalazine agents (also called 5-aminosalicylic acid or 5-ASA) are standard treatment. They are generally administered orally and in addition rectally (enema or suppositories) for rectal disease. Sulphasalazine which consists of sulphapyridine bound to mesalazine, was the first agent to be developed in this category. A major drawback to its use, however, is the fact that doses that provide optimal efficacy are frequently associated with unacceptable side-effects. Asacol is a sulpha-free amino-salicylic agent that delivers the active agent mesalazine in a targeted fashion to the entire colon. In contrast to sulphasalazine it can be administered at higher doses to achieve optimal efficacy without increases in unacceptable side-effects. Once remission is achieved, mesalazine dosing must be continued in order to maintain therapeutic effects.

Patients with moderate to severe UC or patients non-responsive to optimal doses of mesalazine may need treatment with corticosteroids. Their propensity to cause side-effects like increases in blood sugar, fluid retention, moodiness, puffiness, facial acne and bone loss limits their use. Once active disease is controlled, the corticosteroid dose is reduced and after tapering to zero corticosteroids are generally replaced by mesalazine, the dose of which is individually adjusted to each patient’s needs.

Maintenance treatment in patients non-responsive to mesalazine standard therapy or quickly relapsing after steroid tapering (steroid dependant) may be done with immunosuppressives like azathioprine or 6-mercaptopurine.

Always feel free to ask your doctor about your treatment options. Make sure you understand how to take the medicines and what results to expect from them.

Can surgery help me?
In severe cases with persistent relapses, or where the colon becomes very dilated and thin, it may be necessary to perform surgery and remove the colon (colectomy). The remaining bowel will then be either joined to the anus (ileo-anal pouch operation), which is a frequent procedure, or can be opened on to the abdominal wall as an ileostomy (sometimes used transiently to support the healing process or in those rare patients, where the pouch procedure cannot be done). The majority of patients with ulcerative colitis will not require surgery of any kind.