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Ulcerative colitis, commonly known as colitis, is an inflammatory bowel disease. Reducing the inflammation is the primary objective of colitis treatment. Anti-inflammatory drugs are used as the first line treatment for ulcerative colitis.
The abnormal immune response that triggers inflammation in the large intestine is treated with immune system suppressors. Antibiotics, pain relief medications and anti-diarrhea drugs are frequently used for treating the symptoms of ulcerative colitis.
Medications to Treat Colitis
Anti-inflammatory Drugs
Sulfasalazine
Sulfasalazine is a widely used anti-inflammatory drug for treating inflammation of the colon and the rectum. It is usually taken up to four times a day with a snack or after a meal. People on sulfasalazine should drink plenty of fluid each day.
It should be avoided by people with a history of allergy to sulfa drugs. Stomach upset, diarrhea, vomiting, loss of appetite, stomach pain and headache are common side effects of sulfasalazine.
Mesalamine
Mesalamine helps to reduce swelling of the lower part of the colon. This anti-inflammatory drug is available in the form of tablets and suppositories. Mesalamine tablets are usually taken three to four times a day. The suppository is used up to three times a day and as an enema at bedtime for treating rectal inflammation. Sometimes oral drugs are combined with suppositories to provide fast relief from the symptoms of ulcerative colitis. Headache, body pain, joint pain, heartburn, nausea, vomiting, gas, dry mouth, acne, sore throat and hemorrhoids are some of the common symptoms of the drug. Balsalazide, another anti-inflammatory drug used for treating ulcerative colitis, is converted into mesalamine in the body.
Olsalazine
Olsalazine, a derivative of salicylic acid, is used for healing mild to moderate inflammation of the colon and the rectum. Stomach upset, a common side effect of this anti-inflammatory drug can be avoided by taking the drug with food. Loss of appetite, headache, dizziness, joint paint, bloating and blurred vision are common side effects of olsalazine.
Corticosteroids
Moderate to severe inflammation of the large intestine that does not respond to the aforementioned anti-inflammatory drugs are treated with corticosteroids.
These drugs are recommended for short-term use. As the symptoms of ulcerative colitis improve, the dose of the drug is gradually reduced. Corticosteroid use increases the risk of osteoporosis, type 2 diabetes, high blood pressure, cataract, glaucoma, weight gain, infections and growth of facial hair.
Immunosuppressant
Azathioprine
Azathioprine works by suppressing the activity of the immune system. Available in the form of tablets, azathioprine, is taken once or twice a day after meals. However, this immunosuppressant works slowly.
It usually takes at least three months to realize the benefits of the drug. Frequently, azathioprine is prescribed along with corticosteroids to prevent ulcerative colitis flare-ups and prevent recurrence. Nausea, vomiting and diarrhea are common side effects of the drug.
Mercaptopurine
Mercaptopurine belongs to a class of drugs known as purine antagonists. Bone marrow suppression is a serious side effect of the drug. Nausea, vomiting, skin rash, thinning of hair and darkening of skin are common side effects of this drug. Just as azathioprine, mercaptopurine acts slowly. It is therefore combined with corticosteroid drugs to treat ulcerative colitis.
Cyclosporine
Cyclosporine is another immunosuppressive agent used for treating ulcerative colitis. Owing to the toxic side effects of this drug, it is used only for treating severe ulcerative colitis that does not respond to conventional treatment. It is often recommended for ulcerative colitis patients who are not strong enough to undergo surgery.
People on cyclosporine should avoid grapefruit and limit intake of potassium rich fruits such as orange, banana, raisins and prunes. Unlike azathioprine and mercaptopurine, cyclosporine acts fast, displaying its immuno–suppressing effect within one to two weeks. Common side effects of the drug include diarrhea, gas, heartburn, headache, acne, excess hair growth on the face, back and arm, tissue growth on gums, joint pain, tingling in hands and feet, sleeping difficulty, depression and enlargement of breasts in men.
Infliximab
Moderate to severe ulcerative colitis that has not responded to corticosteroids is treated with infliximab. This immunosuppressant drug works by neutralizing the tumor necrosis factor (TNF) linked to inflammation of the large intestine. Surgery can be avoided with the help of this drug. However, infliximab increases the risk of infections. It may also cause blood problems. This immunosuppressant is not recommended for cancer patients, people with a history of cancer and multiple sclerosis patients.
Other Drugs
Fever, a sign of an underlying bacterial infection in ulcerative colitis patients is treated with antibiotics. Your doctor might prescribe anti-diarrheal drug for treating severe diarrhea, a common symptom of ulcerative colitis. However, to diminish the risk of toxic megacolon, anti-diarrheals are used only under medical supervision. Acetaminophen or paracetamol drugs may be recommended for treating mild pain.
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