Medications
Drugs cannot cure inflammatory bowel disease, but they can help reduce the inflammation and accompanying symptoms in up to 80% of patients. The primary goal of drug therapy is to reduce inflammation in the intestine.
Drugs Used. Many drugs are available in different forms and may be used at various stages of the disease.
- Aminosalicylates. The best treatments of ulcerative colitis are preparations of aspirin-like medications called aminosalicylates or 5-ASAs. They are used in all phases of the disease, including maintenance during remission. They may be administered rectally in patients who have mild-to-moderate disease that occurs only in the lower intestine. They may also be taken by mouth.
- Corticosteroids. Corticosteroids (steroids) may be added or used alone to reduce acute inflammation. (They are not recommended for maintenance therapy). Steroids may be administered rectally as an alternative to an aminosalicylate if the disease is limited to the lowest parts of the intestine. Oral forms may treat moderate to severe cases. People who do not respond to less aggressive treatments may need intravenous steroids.
- Immunosuppressants. Drugs that suppress the immune system (immunosuppressants) are useful, either alone or in combinations, for disease that does not respond to other treatments or for maintenance of remissions.
- Biologic Response Modifiers. Unlike drugs that are made from chemicals, biologic response modifiers, (also called biologics), are produced from living organisms. Biologics are designed to stimulate the immune system and interfere with specific proteins (cytokines) involved with the inflammatory response. Infliximab (Remicade) is the first biologic drug approved for ulcerative colitis. It blocks a cytokine called tumor necrosis factor (TNF).
Determining Success. The success of therapy is determined by its ability to induce and maintain remissions without causing significant side effects. The patient's condition is generally considered in remission when the intestinal lining has healed and symptoms such as diarrhea, abdominal cramps, and tenesmus (straining painfully or ineffectively to defecate or urinate) are normal or close to normal.
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