Your healthcare provider will create a care plan for you based on:
- Your age, overall health, and past health
- How serious your case is
- How well you handle certain medicines, treatments, or therapies
- If your condition is expected to get worse
- Your intended family plans, such as getting pregnant
- What you would like to do
There is no special diet for ulcerative colitis. But you may be able to manage mild symptoms by not eating foods that seem to upset your intestines.
Medical treatment may include:
- Medicines. Medicines that reduce redness and swelling (inflammation) in your colon may help to ease your belly or abdominal cramps. More serious cases may need steroids, medicines that fight bacteria (antibiotics), or medicines that affect your infection-fighting system (immune system). Steroids are not a good choice for long-term management. Therefore, your healthcare provider will discuss medicines for long-term control. This may include pills, injections, or a combination. In addition, placing a medicine into the rectum (foam, enema, or suppository) can be very helpful in controlling your symptoms.
- Hospitalization. This may be needed if you have severe symptoms. The goal will be to give you the nutrients you need, stop diarrhea, and replace lost blood, fluids, and electrolytes (minerals).You may need a special diet, IV (intravenous) feedings, medicines, or sometimes surgery.
- Surgery. Most people don’t need surgery. But some people do need surgery to remove their colon. That might happen if you have heavy bleeding, are very weak after being ill for a long time, have a hole (perforation) in your colon, or are at risk for cancer. You may also need surgery if medical treatment fails or if the side effects of steroids and other medicines become harmful.
There are several types of surgery, including the following:
- Proctocolectomy with ileostomy. This is the most common surgery. It is done when other medical treatment does not help. Your entire colon and your rectum are removed. A small opening (stoma) is made in your belly or abdominal wall. The bottom part of your small intestine (the ileum) is attached to the new opening. Your stool will come out of this opening. It will collect in a drainage bag that will be attached to you.
- Ileoanal anastomosis. Your whole colon and the diseased lining of your rectum are removed. The outer muscles of your rectum stay in place. The bottom part of your small intestine (the ileum) is attached to the opening of your anus. A pouch is made out of the ileum. The pouch holds stool. This lets you pass stool through your anus in the normal way. You will still have fairly normal bowel movements. But your bowel movements may happen more often. They may also be more watery than normal.
If your colon remains inside, you will need a colonoscopy at various intervals because of your increased risk of colon cancer.