These drugs are usually the first step in treating UC and other inflammatory bowel diseases.  Aminosalicylates such as as sulfasalazine can effectively reduce UC symptoms.  This medication can produce a variety of side effects, including digestive distress and headaches.  Other medications in this family include mesalamine, balsalazide, and olsalazine.  These medications are available in oral and enema or suppository forms. Cortisteroids, including prednisone and hydrocortisone, are generally used when moderate to severe UC does not respond to other treatments.  They are delivered orally, intravenously, or via enema or suppository.  Steroids can produce many side effects, so they are not usually a long-term treatment. These drugs reduce inflammation too, but they do so by targeting the immune response that produces the inflammation.  Sometimes they are used in combination with a cortisteroid.  Azathioprine and mercaptopurine are the immune system suppressors most commonly prescribed to UC patients. Infliximab, adalimumab, and golimumab are “biologics,” or immune system suppressors that operate by neutralizing a protein that your immune system produces.  These medications are generally prescribed to moderate or severe UC sufferers. Vedolizumab was recently approved for patients who have not responded to other types of immunosuppressant drugs. Always talk with your doctor before beginning a new medication regimen.  Doctors will often recommend one or more of the following in addition to prescription medication:  Antibiotics, especially when a flare-up is causing you to run a fever. Anti-diarrheal medications, especially if your diarrhea has become severe. Acetaminophen for mild pain relief.  Note that ibuprofen, naproxen sodium, and diclofenac sodium can all worsen UC symptoms and should therefore be avoided. Iron supplements to combat anemia, especially if you are experiencing bleeding. Between 20 and 30 percent of people with UC will eventually need to undergo a colectomy (removal of colon) or proctocolectomy (removal of colon and rectum) due to massive bleeding, severe illness, rupture of the colon, or cancer risk.  Surgery does usually eliminate the disease altogether.  Your surgeon will create an internal pouch from a portion of your small intestine that empties into your anus, allowing you to expel waste relatively normally. Note that sometimes it is not possible to construct an internal pouch.  If this is the case, your surgeon will create a permanent opening in your abdomen (a colostomy), through which stool is collected in an attached bag. UC does increase your risk of colon cancer, so it is important to go in for a surveillance colonoscopy every one to two years.
Consult your doctor about anti-inflammatory drugs. Talk to your doctor about immune system suppressors. Use over-the-counter medications to help manage UC symptoms. Talk to your doctor about surgical treatment. Pursue regular colon cancer screening.