Treatment for ulcerative colitis depends on the severity of the disease as well as the choices of the individual. Most people are treated and respond well to drug therapy, but in severe cases the patient may need to have the diseased colon removed. Surgery is considered to be the most curative treatment for ulcerative colitis, but still it has many implications involved that one must consider when making a decision about their treatment. Each person with ulcerative colitis most likely will experience the disease differently from another person so that is why treatment is adjusted for each individual.

For some people symptoms are triggered by certain foods. Avoiding these foods, which cause intestinal upset, like spicy foods, can help to alleviate one�s symptoms. However, the benefit of nutrition as primary therapy for the treatment of ulcerative colitis has not been proven. Since dehydration, decrease food absorption, anemia, and anorexia are all symptoms of ulcerative colitis it is important to have nutritional therapy a component of treatment in order to prevent malnutrition and weight loss. Nutritional status must be optimized through an adequate nutritional intake so that healing can be promoted, one can resist infection, and be able to effectively respond to their medication. The goal is to provide adequate nutrition without making one�s symptoms worse. This may be a challenge at certain times when symptoms are acting up because everything may see to aggravate one�s condition. In severe circumstances a person may have to be hospitalized in order to receive parenteral nutrition, which is when calories, vitamins, minerals and electrolytes are given through a vein. This type of treatment allows for adequate nutrition while giving the bowel a rest.

The literature written on ulcerative colitis identifies that drug therapy is an extremely important aspect of treatment for people with ulcerative colitis and suggests that this intervention is the first step in treating ulcerative colitis. In many cases drug therapy is effective in maintaining remission and in the treatment of mild to moderately severe attacks. Many different medications are used in attempting to control symptoms such as diarrhea, infection, and to alleviate pain. The most common drug used is sulfasalazine, which helps to control inflammation. Sulfasalazine is the drug of choice because it can be used for as long as needed and can be given along with other drugs. People who do not respond to sulfasalazine may be treated with corticosteroids. Prednisone and hydrocortisone are two types of corticosteroids that are proven to reduce the inflammation in the colon. These drugs can be given in different forms to better treat the condition. Depending on the location of inflammation, medication can be given, orally, intravenously, through an enema, or in a suppository. Corticosteroids can cause a variety of significant side effects, so doctors carefully monitor patients taking these drugs. Immunosupressive drugs have also been used in severe cases of ulcerative colitis when a patient has failed to respond to any of the usual medications and before surgery is considered. People taking these drugs need to be monitored closely by a doctor, since there can be many severe side effects.

When one does not adequately respond to pharmacological intervention surgery is unavoidable and approximately 25% of patients with ulcerative colitis end up having their entire large intestine removed. There are several surgeries that can be done in order to remove the colon, but which surgery to have depends on the severity of the disease and the patient�s needs, expectations, and lifestyle. The recent and most restorative surgical procedure done on people with ulcerative colitis is a total colectomy with the ileoanal anastomosis. This procedure is done in two to three stages approximately eight to 12 weeks apart. The surgeon connects the terminal ileum to the inside of the rectum and anus creating a pouch where waste is stored and passed through the anus. Bowel movements tend to me more watery and frequent, but this improves with time. Surgical intervention is considered to be one of the main treatments for relieving the overwhelming symptoms of ulcerative colitis in those individuals who are not able to achieve remission. However, one must also consider the potential postoperative complications of surgery against the symptoms of active colitis.

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