Treatment for UC depends on how severe the symptoms are and how far the inflammation reaches round the colon.

Initially, especially if your UC is mild, you will probably be treated with 5-ASA drugs such as mesalazine or sulphasalazine. You may also be given corticosteroids. These medications help reduce the gut inflammation typical of UC. Once the active inflammation has gone into remission, 5-ASAs are usually prescribed as maintenance therapy to reduce the chance of a flare-up.

Immunosuppressant drugs, such as azathioprine or mercaptopurine may be prescribed for people with UC who continue to have frequent flare ups or ongoing symptoms. For more severe UC, treatment with corticosteroids given intravenously (directly into a vein, through a drip) may be necessary. You may also be started on a biologic medication such as infliximab or a small molecule medication, such as tofacitinib for induction and maintenance.

If the disease is very severe and is not responding to medical therapy, your doctor may suggest surgery to remove part or all of the large bowel. This usually means having an ileostomy and a stoma bag, at least temporarily. The colorectal surgeon will discuss with you options of either a permanent stoma or an internal pouch (IPAA - ileal pouch anal anastomosis). Although the idea of bowel surgery can be daunting, many people find they can cope better with a stoma or a pouch than with the UC symptoms they were previously experiencing.

For more information see our MedicationsSurgeryDiet, and Ostomy care sections.