Initial treatment for ulcerative colitis usually involves medicine to treat and relieve symptoms. Medicines known as corticosteroids are the primary therapy for moderate-to-severe and fulminant (sudden) ulcerative colitis. While these drugs are effective in achieving remission or getting ulcerative colitis under control, they have not proven effective in preventing relapses.⁸

Other types of medicine, known as aminosalicylates, are the primary therapies for mild-to-moderate ulcerative colitis. Drugs known as immunomodulatory agents, for their ability to affect the way your immune system responds, are used both to control active cases and to maintain remission of ulcerative colitis. Antibiotics and medicines known as biologic agents (compounds made from living organisms and their products, such as proteins, genes, and antibodies) are also used to treat ulcerative colitis.⁸

Complications are not an inevitable, or even a frequent, consequence of ulcerative colitis, if treated appropriately. Complications can include profuse bleeding from deep ulcerations, rupture of the bowel, severe abdominal distension, or failure to respond to medical treatments.

See a diagram of minimally invasive surgery and open surgery for ulcerative colitis.

Watch an animation of what happens during minimally invasive surgery and open surgery for ulcerative colitis.

During surgery for ulcerative colitis, known as a proctocolectomy, the entire colon is removed through an incision in the abdomen. A proctocolectomy is usually followed by one of the these two operations:

• An ileostomy, in which the surgeon creates a small opening in the abdomen and attaches the end of the small intestine to it. Waste travels through the small intestine and exits the body into a pouch worn over the opening.

• An ileoanal anastomosis, which allows the patient to have normal bowel movements because it preserves part of the anus. The surgeon removes the diseased part of the colon and attaches the small intestine to the inside of the rectum and the anus, creating a pouch. Waste passes through the anus in the usual manner.

During traditional open surgery, the surgeon makes an incision up to 12 inches long from the upper to the lower abdomen to remove the colon. Because of the nature of this procedure, patients often face a healing process that results in a hospital stay of at least a week, with recovery time ranging from six to eight weeks.⁹

You now have another surgery option for ulcerative colitis, a minimally invasive colon surgery, also known as laparoscopic surgery.

Find out more about minimally invasive colon surgery for ulcerative colitis and whether or not minimally invasive colon surgery may be an option for you.

With both open surgery and minimally invasive colon surgery, you will need time to heal. You will be on intravenous fluids and pain medication and will not be able to eat for the first couple of days. You probably will feel tired and weak, and possibly have some constipation for some time. Your healthcare team will monitor your progress and work to get you back to normal as quickly as possible.