Colitis: Treatments

How is colitis treated?

Treatment of colitis depends on the underlying disease, disorder or condition. The goals of treatment are to relieve symptoms and correct the underlying problem if possible.

Infectious colitis is treated based on the organism (bacteria, virus or parasite) that is known or likely to be causing the infection. Antibiotics may be used for bacterial infections. Supportive treatments and treatments aimed at preventing dehydration and relieving symptoms may also be part of the treatment plan for infectious colitis.

Inflammatory causes of colitis are generally treated with anti-inflammatory medications, such as mesalamine and sulfasalazine. Other classes of medications used to treat inflammatory colitis include:

• Antibiotics

• Biologic therapies such as infliximab (Remicade)

• Corticosteroids such as prednisone

• Immune modifiers such as azathioprine (Imuran)

Other types of colitis are treated based on the underlying disease, disorder or condition. For example, treatment of irritable bowel syndrome is aimed at relieving symptoms. Ischemic colitis is treated by trying to restore blood flow, relieving symptoms, and performing surgery if necessary.

Other treatments for colitis

Other methods for controlling colitis include a variety of therapies, lifestyle, and dietary interventions, and possibly surgery. Additional treatments of colitis include:

• Dietary changes, such as drinking extra fluids to prevent dehydration, eating a low-fat diet, and limiting dairy products and any other foods that seem to aggravate your symptoms

• Getting regular exercise

• Intravenous nutrition to ensure adequate nutrition if you are unable to eat because you need to rest your gastrointestinal tract

• Intravenous rehydration and electrolyte replacement if frequent diarrhea has resulted in the loss of excessive fluid and electrolytes, causing severe dehydration and electrolyte imbalances

• Reducing stress

• Regular medical care to monitor symptoms, modify treatment plans as needed, and watch for possible complications

• Smoking cessation program if you smoke

• Surgery to remove a damaged colon and rectum. This major surgery, called a proctocolectomy, involves joining your remaining small intestine to the abdominal wall and connecting an external pouch to collect intestinal waste. Restorative proctocolectomy, or ileoanal pouch-anal anastomosis (IPAA), is a newer procedure that involves connecting the end of the small intestine directly to the anus, thus preserving your ability to pass feces through the anus.

What are the potential complications of colitis?

Complications of untreated or poorly controlled colitis can be serious and life threatening. You can best treat colitis and lower your risk of complications, or delay the development of complications, by following the treatment plan you and your healthcare professional design specifically for you.

Colitis can lead to serious complications including:

• Dehydration

• Fistulas (abnormal holes between the gastrointestinal tract and other areas of the body, such as the vagina, bladder and skin). Fistulas can become seriously infected and cause other problems.

• Intestinal bleeding

• Intestinal perforation or rupture of the intestinal wall

• Intestinal ulceration

• Malnutrition

• Peritonitis

• Shock

• Toxic megacolon