The main method of controlling ulcerative colitis symptoms is the use of medication. The drugs used offer several advantages:They are easy to take in the oral form.
Enema and suppository formulations are very fast acting.
They provide pain relief and control of diarrhea.
They provide hope by extending periods of remission and minimizing flare-ups.
By controlling inflammation they help promote healing.
Classes of Drugs Used to Treat UC
Drugs that control the immune response
Specific Medications Used for UC. Drugs commonly used to treat diarrhea are the aniticholinergic drugs loperamide (Imodium®) or mild to strong opiates. Opiate treatments include drugs like diphenoxylate, opium tincture or codeine. See the side-effects section below for the risks associated with this type of medication.
Inflammation is generally treated with anti-inflammatory medications: nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. One common anti-inflammatory is sulfasalazine (or mesalamine), which in addition to controlling inflammation also helps control diarrhea, bleeding, and pain. Mesalamine can be administered orally, or as an enema or suppository. After the inflammation subsides, mesalamine is tapered off and dosages are adjusted to combat flare-ups.
Inflammation can also be controlled with the use of drugs that control the immune system response. For example, azathioprine, 6-mercaptopurine, and cyclosporin A, are sometimes used in severe cases of UC. These “immune modulators” suppress B- and T-cell function and activity, an important aspect of the immune system. Dependency on corticosteroid drugs can be limited by the administration of immune modulators.
Antibiotics are used to treat secondary bacterial infections that often accompany UC. Metronidazole and ciprofloxacin (“cipro”) are the commonest antibiotics used in inflammatory bowel disease treatment. Some research indicates that antibiotics may also be affective at treating the disease directly.
Toxic Megacolon and Other Side Effects. Side effects of anti-diarrheal medications include constipation and dehydration. Use of anti-diarrheals must be carefully monitored as overuse can result in a serious complication called toxic megacolon. In this potentially life-threatening condition, the colon becomes enlarged and does not properly empty.
The extended use of corticosteroid drugs renders side effects such as a decreased immune response to infection and bone density loss, which can lead to osteoporosis.