Ulcerative Colitis

Treatment plan for ulcerative colitis

What are the treatment options for ulcerative colitis?

Ulcerative colitis can affect you in many different ways, and not many people are affected the same way. Someone with mild ulcerative colitis may get better on their own without needing medication, whereas someone else with severe disease may need to have surgery right away to get their symptoms under control. That is why your treatment plan is developed just for you, based on your situation and how your ulcerative colitis is affecting you.

Your treatment plan will be based on the following four elements:

• The severity of your ulcerative colitis

• Your past health and treatment history

• How your ulcerative colitis is expected to progress (called ‘prognosis’)

• Your personal needs, wishes and expectations

How can treatment help?

Management of ulcerative colitis aims to:

• Treat acute attacks (flares) promptly and effectively

• Maintain remission via the appropriate use of drug therapy

• Take into account people who will benefit from surgery

• Ensure appropriate nutritional care and support is provided

• Consider needs of those being treated at home or leaving hospital

• Weigh the benefits and risks for any approach

When you have a flare, the goal of treatment is to relieve symptoms as promptly and effectively as possible – doctors refer to this as ‘induction of remission’. Once your symptoms are under control, the next goal is to keep your symptoms under control. That is called ‘maintenance’.

Guidelines on severity of ulcerative colitis

Your doctor will talk to you about your illness and whether it is considered mild, moderate or severe. The following guidelines are often used:

Mild

• <4 runny stools per day

• Little or no bleeding

• No signs of systemic effects (eg, fever, raised pulse or blood counts)

Moderate

• 4–6 runny stools per day

• Moderate bleeding

• Some signs of systemic effects (eg, fever, raised pulse or blood counts)

• Mild disease that does not respond to treatment

Severe

• >6 runny stools per day (often at night)

• Severe bleeding

• Signs of systemic effects (eg, fever, raised pulse or blood counts)

• Signs of malnutrition

• Weight loss in excess of 10% of your weight when well

Some people with ulcerative colitis may have a few flares that require treatment in their lifetime, whereas others with more severe illness may find they need care continuously that may include surgery or long term treatment to keep symptoms under control. Based on your situation, you and your doctor will decide which treatment and care will be right for you.