Medications for Ulcerative Colitis: A Guide to Western Medical Treatments

Western medicine offers a variety of treatments aimed at managing symptoms, reducing inflammation, and maintaining remission. In this article, we will explore the main medications prescribed for UC, their effects, and potential side effects.

1. Aminosalicylates (5-ASA)

Aminosalicylates are anti-inflammatory drugs used to manage mild to moderate UC symptoms.

Common Medications:

• Mesalamine (Asacol, Lialda, Pentasa, Apriso)

• Sulfasalazine (Azulfidine)

• Olsalazine (Dipentum)

• Balsalazide (Colazal)

Mechanism of Action:

These drugs work by suppressing specific immune system chemicals to reduce inflammation in the colon.

Side Effects:

• Nausea, headaches, diarrhea

2. Corticosteroids (Steroids)

Corticosteroids are used for short-term treatment during acute flare-ups in patients with moderate to severe symptoms. However, they are not suitable for long-term use due to significant side effects.

Common Medications:

• Prednisone

• Budesonide (Uceris, Entocort EC)

Mechanism of Action:

These drugs suppress the immune response, rapidly reducing inflammation.

Side Effects:

• Weight gain, high blood pressure, blood sugar fluctuations

• Long-term use increases the risk of osteoporosis and infections

3. Immunomodulators

If 5-ASA or corticosteroids are ineffective, immunomodulators may be used for long-term management.

Common Medications:

• Azathioprine (Imuran)

• 6-Mercaptopurine (6-MP, Purinethol)

• Methotrexate (less commonly used for UC)

Mechanism of Action:

These drugs suppress the immune system to prevent abnormal attacks on the colon.

Side Effects:

• Increased risk of infections

• Liver toxicity and bone marrow suppression

4. Biologic Therapies (Biologics)

Biologics target specific immune system pathways involved in inflammation and are used for moderate to severe UC cases.

Common Medications:

• Anti-TNF Agents:

  • Infliximab (Remicade)

  • Adalimumab (Humira)

  • Golimumab (Simponi)

• Integrin Inhibitors:

  • Vedolizumab (Entyvio)

• IL-23 Inhibitors:

  • Ustekinumab (Stelara)

Mechanism of Action:

These drugs block specific proteins that trigger inflammation, helping to maintain remission.

Side Effects:

• Increased risk of infections

• Allergic reactions and infusion-related side effects

Western medicine provides a range of effective treatment options for ulcerative colitis. The choice of medication depends on the severity of the disease, the patient’s response to previous treatments, and potential side effects. While these drugs help manage symptoms and maintain remission, patients should work closely with their healthcare providers to determine the most suitable treatment plan for their condition. Ongoing research continues to improve UC treatment strategies, offering hope for better outcomes in the future.