Alternatives to Steroid Therapy for Ulcerative Colitis

Ulcerative colitis is an auto-immune disease of the colon where the interior lining of the colon becomes inflamed and develops open sores or ulcers. Though it is much studied there is no identified reason why people get the disease. No cure has been developed but there have been great advancements in the treatment of the disease. There are five non-steroid methods of treating ulcerative colitis which can be discussed with your gastroenterologist.

Aminosalicylates (5-ASA)

This type of drug therapy helps to control inflammation and is usually effective in mild to moderate cases of ulcerative colitis. The 5-aminosalicyclic acid is an anti-inflammatory which is combined with a carrier to get it to the intestine. This type of drug comes in a variety of brands, some more easily tolerated then others. Aminosalicylates are extremely effective maintenance treatments and help prevent relapses.

Immune Modifiers

These medications are used to reduce or eliminate the patient’s dependence on corticosteroids. Just as it sounds, these drugs suppress the immune system and are normally used in patient who have not responded to standard treatments. The biggest drawback to this method is the fact that immune modifiers can take up to three months before they even begin to work and six months to fully work. There are also side effects that have to be monitored, since the patient’s immune system is suppressed.

Antibiotics

In ulcerative colitis, the body’s immune system reacts to the natural bacteria found in the intestines. Antibiotics can be used to reduce the inflammation caused by the body’s natural immune system by reducing the bacteria. Drugs like Rifaximin work specifically on the intestinal bacteria and have little effect on the rest of the body.

Biologic Therapies

Infliximab is the newest drug to treat moderate to severe ulcerative colitis. The drug acts to block the pathway of TNF. TNF is an immunologic signaling protein that is believed to promote the inflammation that causes ulcerative colitis and Crohn’s disease. This type of treatment is for patients who do not react well to standard drug therapy. Patients on biologic therapy have to be carefully monitored for infection because it suppresses the immune system. There is also a risk for a rare type of cancer in some patients.

Surgery

If the ulcerative colitis becomes severe and uncontrollable, affects quality of life in the most negative way or gives signs of cancer, surgery may be the solution. Only about 25 to 33 percent of patients experience complications severe enough to warrant surgery. With ulcerative colitis, surgery means removal of the rectum and colon and an end to the disease. A proctocolectomy is a very serious decision, not to be made without discussion and much thought.