Is Ulcerative Colitis Curable, or Is Symptom Remission Possible?

Medically reviewed by Robert Burakoff, MD

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD). There is no known cure for ulcerative colitis. However, with proper medical care, it is possible to reduce and manage symptoms while keeping the colon intact.

While flare-ups may occur, successful remission of symptoms is a main goal of individualized treatment plans. Treatment may include medicines and/or surgery and additional complementary therapies to help manage symptoms.

This article will discuss if ulcerative colitis is curable, the treatments available, if symptoms can go into remission, and how to manage triggers and flare-ups.

IBD and Ulcerative Colitis Cure: What Is Known?

Ulcerative colitis causes inflammation and ulcers on the inner lining of the large intestine (colon).

There is no cure for UC. It is considered to be a lifelong condition. However, treatments are available to help reduce and manage symptoms.

A total colectomy (removal of the entire colon) may be recommended in very severe cases. In this case, it can resolve all colon-related UC symptoms. Still, with UC being an immune-mediated condition, symptoms related to other organs may persist.

About 25% to 40% of people with IBD, including UC and Crohn’s disease, experience symptoms in parts of the body besides the colon, such as the liver, kidneys, joints, skin, bones, and eyes.

One study found that nearly 20% of people with UC experienced liver problems. These issues may continue even after undergoing a colectomy.

Nevertheless, UC is treatable, and most individuals with UC can expect to live a full life. In some cases, very severe UC or the development of complications may impact life expectancy.

Available Ulcerative Colitis Treatments

Available conventional treatment for UC includes medication and surgical options. Ongoing research is advancing UC treatment options for those living with the condition.

Medication

Different classes of medications are used to treat UC.

Aminosalicylates (5-ASA): This class of medications for mild to moderate UC helps individuals with UC stay in remission. They help decrease inflammation in the lining of the colon. This class includes:

• Apriso, Canasa, Delzicol, Lialda, Pentasa, Rowasa (mesalamine)

• Azulfidine (sulfasalazine)

• Colazal (balsalazide)

• Dipentum (olsalazine)

Biologics/biosimilars: This class of medications is used to treat moderate to severe UC and help individuals with UC stay in remission. Biologics neutralize proteins made by the immune system, helping to reduce inflammation in the gut. This class includes:

• Abrilada (adalimumab-afzb)

• Amjevita (adalimumab-atto)

• Avsola (infliximab-axxq)

• Cyltezo (adalimumab-adbm)

• Entyvio (vedolizumab)

• Hadlima (adalimumab-bwwd)

• Hulio (adalimumab-fkjp)

• Humira (adalimumab)

• Hyrimoz (adalimumab-adaz)

• Idacio (adalimumab-fkjp)

• Inflectra (infliximab-dyyb)

• Ixifi (infliximab-qbtx)

• Omvoh (mirikizumab-mrkz)

• Remicade (infliximab)

• Renflexis (infliximab-abda)

• Simponi (golimumab)

• Stelara (ustekinumab)

• Yuflyma (adalimumab-aaty)

• Yusimry (adalimumab-aqvh)

Corticosteroids (steroids): This medication class helps suppress immune system inflammation. They are used short-term to treat moderate to severe UC and those with mild to moderate UC who don’t respond to aminosalicylates. This class includes:

• Depo-Medrol, Medrol Dosepak, Solu-Medrol (methylprednisolone)

• Pediapred (prednisolone)

• Prednisone

• Uceris (budesonide)

Immunomodulators (immunosuppressants): This class of medication is used to treat moderate to severe UC and helps individuals with UC stay in remission. They may also be used to treat severe UC in individuals who do not respond to other medications. They decrease the activity of your immune system, helping to decrease inflammation in your colon. This class includes:

• Imuran (azathioprine)
  

• Neoral, Sandimmune (cyclosporine)

• Prograf (tacrolimus)

• Purinethol, 6-MP (mercaptopurine)

Targeted synthetic small molecules: This class of medications is newer and may be prescribed for adults with moderate to severe UC who don’t respond to other medications or who have severe side effects with other medications. They suppress specific parts of the immune system with the aim of helping decrease inflammation. This class includes:

• Rinvoq (upadacitinib)

• Velsipity (estrasimod)

• Xeljanz (tofacitinib)

• Zeposia (ozanimod)

Surgery

Sometimes, medication is not enough to completely manage UC symptoms and complications can arise. In 25% to 30% of people with UC, surgery is recommended. This involves removing part or all of the colon (colectomy) and sometimes the rectum (proctocolectomy).

The decision to remove all or part of the colon should not be taken lightly, as it changes how your body stores and passes stool and the ability to absorb some nutrients. It’s important to keep in mind that most people with UC don’t require surgery.

Your healthcare provider can review the risks and benefits of having the surgery to see if it is the right option for you.

Advancements in Ulcerative Colitis Treatment

Previously, when removing the colon, an ileostomy or external stoma was required to help excrete waste from the body. This is an opening in the abdomen through which stool is emptied into a pouch that is attached to the skin with adhesive.

Advancements in surgical treatments have made it possible to avoid the creation of an ileostomy in some cases and instead create an internal pouch from the small intestine attached to the anal sphincter muscle. This eliminates the need to wear an external pouch to collect waste. It improves quality of life.

Some classes of medication, such as biologics and targeted synthetic small molecules, are rapidly developing with new research from studies and trials being conducted. Clinical trials are often available as an option for treating IBD, allowing researchers to find additional ways to expand and improve treatment options.

Complementary Therapies for Ulcerative Colitis

While medication and surgery are the two main treatments for UC, there are potential alternative and complementary remedies. Always talk with your healthcare provider before changing or adding any new therapies to your UC treatment plan.

Complementary therapies for UC may include:

• Meditation and yoga

• Acupuncture

• Turmeric (curcumin)

• Herbs

• Omega-3 fatty acids

• Probiotics

• Regular physical activity

• Avoiding food triggers

• Eating small, more frequent meals
  

Can Ulcerative Colitis Symptoms Go Into Remission?

While UC is considered a lifelong chronic condition, it doesn’t mean individuals living with the condition are always experiencing symptoms related to it. It is possible to manage and achieve remission of symptoms successfully. This is when symptoms are greatly reduced or disappear altogether.

Remission periods may last anywhere from weeks to years. The goal of treatment is to stay in remission long term.

It’s important to work with your healthcare team and communicate with them if anything changes with your symptoms or disease activity. They can guide you in finding the right approach to help keep your symptoms at a minimum.

Achieving Remission With Mild vs. Severe UC

Depending on the severity of your UC, your treatment options will vary. However, whether your UC is mild or severe, treatment goals always include reducing or eliminating inflammation and achieving remission.

It is possible to greatly reduce symptoms or even have no symptoms for periods with both mild and severe UC. More severe cases may take longer, with more trial and error, to attain remission. After finding the most effective treatment plan for you, symptoms should decrease.

Managing Incurable Symptoms and Ongoing Flares

Managing symptoms of UC will be by trial and error to see what works best for you. Pay close attention to your symptoms and what may have triggered or made them worse.

Eating a healthy, varied diet is important for people with UC. While food does not cause UC, some people with the condition have found that some foods tend to aggravate symptoms. Keeping a food diary can help you target your potential food and beverage triggers.

During times of flares, some people have found that avoiding spicy and high-fiber foods helps minimize symptoms. Other foods that may trigger or worsen symptoms include carbonated, caffeinated, or alcoholic beverages. In addition, if you are lactose-intolerant, avoiding dairy products may help manage symptoms, as well.

Other lifestyle habits that may manage symptoms include:

• Getting enough quality sleep each night

• Reducing stress

• Exercising

Summary

There is no cure for ulcerative colitis (UC). However, treatments including medication and surgery can help decrease symptoms and improve quality of life. With ongoing research, advancements are being made in how UC is treated.

Alternative and complementary therapies are available, but it’s best to talk with a healthcare provider before changing your treatment plan or trying something new.

Despite not having a cure, remission of symptoms is possible for people living with UC, which can last from weeks to years. Flare-ups may occur, and managing symptoms during these times may be achieved through medication, diet, exercise, and other lifestyle habits.

Working closely with your healthcare team, you can find the right treatment plan to help you get to and stay in remission over the long term.

Read the original article on Verywell Health.