Colitis

Treatment for colitis depends on the type and severity of your condition. Some types of colitis can be managed with dietary changes, and many types of colitis can be controlled with a range of medications.

For more severe cases or those not managed with medicine, surgical options for colitis treatment are available.

Dietary changes

Making changes to your diet can go a long way toward reducing inflammation and preventing flare-ups if you have a chronic colitis condition. Eating smaller meals more often, staying hydrated, and drinking without a straw (which causes you to ingest air, causing gas) can reduce your symptoms. Dieticians available at NewYork-Presbyterian can create a customized regimen to improve mild symptoms without medications or surgery.

You can also avoid foods known to trigger abdominal pain and other symptoms of colitis, such as insoluble fiber foods (including raw green vegetables, fruits with skin, and whole grains), lactose, caffeine, alcohol, and foods high in sugar and fat content. Replace these foods with low-fiber fruits (like bananas and melon), lean proteins, fully cooked vegetables, and dietary supplements to round out your nutritional needs.

Medication

• Anti-inflammatory medications are typically the first method used to control symptoms since colitis is a result of inflammation. These include 5-aminosalicylates, such as sulfasalazine and mesalamine, and corticosteroids, such as prednisone and budesonide, which are often used for more severe cases that don’t respond to other treatments.
• Immunosuppressants reduce swelling by suppressing the immune system, which initiates the process of inflammation. These include azathioprine and mercaptopurine, typically used to treat inflammatory bowel diseases.
• Biologics target proteins the immune system creates and are typically used to treat ulcerative colitis. The first medication used to treat inflammatory bowel disease (IBD) was tumor necrosis factor (TNF) inhibitors, which neutralize a protein naturally created by the immune system as part of an inflammatory response. Since then, many biologic medications have been created to target different pathways of the immune response.

Your doctor may also recommend over-the-counter medications such as anti-diarrheal medicines (like Imodium) and pain relievers (like Tylenol), or prescription-strength antispasmodic medications to be used during flare-ups.

Surgical options

For cases of ulcerative colitis that are not responsive to medications or dietary changes, your doctor may recommend a proctocolectomy, the process of surgically removing your entire colon and rectum. This procedure typically involves the construction of a pouch at the end of your small intestine, which is then attached to the anus, allowing for normal waste excretion.

This is commonly referred to as a “J-pouch” because the bowel resembles a “J” to function as a reservoir for stool before defecation to mimic the rectum before being surgically removed.