Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). Although treatment options and relief methods have improved in the past several years, there is still no cure for UC.

Treatment options for UC typically focus on helping manage symptoms, such as inflammation. In severe cases, a healthcare professional may recommend the removal of the colon.

This article explores some treatment options for UC, including natural remedies, and provides information about ongoing research into developing better treatments for the condition.

Researchers are continuously looking into new treatments and trying to increase their understanding of how UC affects the body.

For example, a team at the Stanford University School of Medicine recently reported on a study examining the microbes in a person’s gastrointestinal (GI) tract. The study found that people with UC had a deficiency in the amount of good bacteria in their GI tract.

Good bacteria help prevent inflammation. New treatments that aim to correct imbalances in bacteria may help relieve UC symptoms.

New medications

Researchers are constantly looking into new medications that can help manage the symptoms of UC. Recently, the Food and Drug Administration (FDA) has approved new medications to help treat certain aspects of UC.

One of the recent medications with FDA approval is mirikizumab-mrkz (Omvoh). Health experts have shown this drug can help with bowel urgency in people with UC.

Another medication that the FDA approved in 2023 was etrasimod (Velsipity). Velsipity can help with inflammation in those with moderate to severe UC.

Individuals can speak with their healthcare professionals about new and developing treatments for UC.

Clinical trials for UC

Clinical trials are studies that involve people testing new forms of treatment. A person can sign up for a clinical trial as long as they meet the criteria for the study. Before signing up, they need to talk with a healthcare professional about the possible risks and benefits of joining an investigational study.

People interested in joining a study can also talk with a healthcare professional to see if they know of any upcoming studies for which they may qualify. Interested individuals can also visit ClinicalTrials.gov to find UC studies across the country.

A healthcare professional who is treating UC has several options. The goal of treatment is typically to help reduce inflammation, prevent flares, and improve a person’s overall quality of life.

The Crohn’s & Colitis Foundation identifies three main treatment options for those with UC. These options are:

  • medications
  • diet and nutrition
  • surgery

Medications for UC

Healthcare professionals typically prescribe UC medications according to the condition’s severity.

For mild to moderate cases, they often prescribe oral or rectal aminosalicylates. These are anti-inflammatory medications containing 5-aminosalicylic acid, including:

  • balsalazide
  • mesalamine
  • sulfasalazine

For moderate to severe cases, a healthcare professional may prescribe corticosteroids with or without other medications to bring the condition into remission. Once it is in remission, the goal is to limit corticosteroid use. At that point, they may prescribe immunosuppressants, such as thiopurines, which include mercaptopurine or azathioprine.

Healthcare professionals may also prescribe biologics, which are products that derive from living cells. Biologics that people with UC use include:

  • anti-integrins
  • Janus kinase inhibitors
  • anti-tumor necrosis factor agents

A healthcare professional may also prescribe additional medications, such as antibiotics, to treat infections. People sometimes get infections as a complication of UC and immunosuppression.

Those with UC also need to avoid using nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin, to avoid triggering symptoms.

Dietary changes

Making dietary changes can play a role in a person’s overall health and continued remission of UC. Although no one diet will help everyone, some diets may be better than others for people with the condition.

The University of Massachusetts Medical School created an IBD diet to help restore the balance of gut bacteria. Research suggests that imbalances in bacteria may be partially responsible for IBD symptoms.

The diet emphasizes four different components for optimal health and control of UC. The four components are:

  • Prebiotics: These help feed good bacteria in the gut and contain soluble fiber. They include steel-cut oats, vegetables, chia seeds, flax seeds, and bananas.
  • Probiotics: These are fermented foods containing live bacteria, such as yogurt, kimchi, and miso.
  • Good nutrition: A healthy diet should include fruits, lean proteins, healthy fats, and vegetables.
  • Avoidance: Inflammatory foods to limit or avoid include those containing corn, lactose, high amounts of saturated fat, refined sugar, and wheat, as these interfere with gut flora.

Dietary changes, though important in many cases, should not take the place of a healthcare professional’s recommended treatment plan. A person also needs to consult a healthcare professional before making any major dietary changes.

Surgery

According to one 2019 study, 15% of people with UC may need surgery to help treat the condition.

This statistic has decreased dramatically in recent years, and the Crohn’s & Colitis Foundation credits the use of biologics.

The percentage of people who needed their colon removed in the year after their first hospitalization dropped to 5.3% from 20% several years ago. The share of those who needed a colectomy within 1 year of hospitalization also fell to 11.9% from 30%.

Herbal medicines and complementary therapies will not cure UC. There is limited clinical evidence for the safety and effectiveness of herbal medicine.

In a 2012 review, researchers noted that a small study of 118 people with UC symptoms found that traditional Chinese medicine (TCM) helped 84% of the participants. This was in comparison with 60.5% of those who received prednisone treatment.

Some TCM therapies for UC include:

  • wheatgrass juice
  • aloe vera gel
  • Boswellia serrata, an Ayurvedic herb
  • bovine colostrum enemas, which may have anti-inflammatory effects

The researchers added that herbal remedies are prevalent and may be safer overall than Western medications.

In a 2018 review of various complementary and alternative therapies, researchers listed several different treatment options that may help with UC. They included:

  • TCM
  • acupuncture
  • herbal supplements, such as turmeric

There were limited studies showing a decrease in symptoms among people using cannabis, but the authors advised against its use for UC. Due to some adverse effects, more research is necessary.

The review also suggested that those with UC may benefit from complementary treatments that help with mental well-being. Such remedies include:

  • yoga
  • exercise
  • cognitive therapy

A person needs to continue to follow the treatment guidelines they agreed upon with a doctor. They also need to discuss any possible changes to their routines.

Although complementary therapies may help, people need to be wary of any therapy that promises a cure for UC.

Ulcerative colitis (UC) does not currently have a cure. Treatment options include different medications, dietary changes, and some complementary therapies. These can help a person achieve and maintain remission.

Research into UC is ongoing and includes exploring new treatment methods.