Conventional Medical Treatments for Colitis

What is colitis?

Colitis is a health condition that involves inflammation of the large intestine, or colon. Colitis symptoms range from mild to severe. The main types of colitis include ulcerative colitis, pseudomembranous colitis, ischemic colitis, and microscopic colitis.

• Ulcerative colitis (UC) occurs when the immune system mistakenly attacks healthy bacteria in the gut. This causes inflammation in the colon, which may lead to bleeding ulcers.
• Pseudomembranous colitis (PC) occurs due to an overgrowth of Clostridium difficile bacteria. In some cases, taking antibiotics can kill healthy bacteria and cause an overgrowth of bad bacteria, including Clostridium difficile bacteria.
• Ischemic colitis (IC) occurs when blood flow to the colon is blocked. This may be due to a blood clot or fatty deposits (atherosclerosis) within the blood vessels.
• Microscopic colitis (MC) involves colon inflammation that can only be seen under a microscope. Symptoms typically include chronic watery diarrhea, abdominal pain, and bloating.

Conventional medical treatments for colitis

Treatment for colitis varies depending on the type of colitis, overall health and age, and the severity of the condition.

General treatments for all types of colitis include limiting intake of food and liquids by mouth (bowel rest) and taking medications for pain, inflammation and spasms. Condition specific treatments include the following:

Ulcerative colitis

• Aminosalicylates, such as sulfasalazine and mesalamine, may be prescribed to reduce inflammation. These can be administered in pill or enema form.
• Immunosuppressants may be prescribed to calm the immune system’s response. Examples include azathioprine and allopurinol.
• Biologics are similar to immunosuppressants, but instead of suppressing the entire immune system, they target and suppress a specific segment of the immune system to reduce inflammation. Biologics commonly used to treat UC include adalimumab and etanercept.
• Steroids, such as budesonide and prednisone, are often prescribed to treat UC.
• Surgery to remove all or part of the colon or rectum may be necessary in severe cases.

Pseudomembranous colitis

• Antibiotics are usually prescribed to treat the C. Difficile infection. Antibiotics used to treat pseudomembranous colitis include metronidazole, vancomycin, or fidaxomicin.
• Fecal transplant from a healthy donor can be used to restore the balance of bacteria. This treatment is only used in extremely severe cases.
• Surgery to clean out the colon, or lavage, is a newer surgical approach. Surgery may also be necessary to remove all or part of the colon.

Ischemic colitis

• Bowel rest is usually sufficient in most cases.
• Surgery to repair the bowel and remove dead tissue may be necessary in severe cases.

Microscopic colitis

Medication is the main treatment for microscopic colitis.

• Anti-diarrheal agents
• Immunosuppressants that calm the immune system response may be prescribed. Examples include azathioprine, allopurinol or methotrexate.
• Biologics are similar to immunosuppressants, but instead of suppressing the entire immune system, they target and suppress a specific segment that causes inflammation. Biologics commonly used to treat MC include adalimumab and etanercept.
• Steroids, such as budesonide and prednisone, may also be prescribed.