Many Effective Therapies Available to Control Ulcerative Colitis
David Bruining, M.D.

DEAR MAYO CLINIC:

What is the latest research for ulcerative colitis and proctitis? Is there still no cure?

ANSWER:

Although ulcerative colitis currently has no medical cure, many effective therapies are available to control its symptoms. In addition, extensive research is under way to study the cause, diagnosis and treatment of inflammatory bowel disease. Findings from those studies may help researchers discover new ways to improve the management of ulcerative colitis.

Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation within the colon. When only the rectum is involved, the condition is known as ulcerative proctitis. Signs and symptoms of ulcerative colitis vary, depending on the extent and severity of the disease. Common signs and symptoms include rectal bleeding, pain, bloody diarrhea and abdominal cramps. In some cases, ulcerative colitis may also cause inflammation of other organs, including the joints, eyes and skin.

What causes ulcerative colitis is not clear. Many researchers believe that the digestive tissue damage people experience with ulcerative colitis is caused by an inappropriate or poorly regulated immune response. In other words, ulcerative colitis could be an autoimmune disorder, in which the immune system attacks the body's own tissues and organs, causing inflammation and damage.

Medications that control inflammation are usually the first step in treatment for ulcerative colitis. For people with proctitis, mesalamine (also known as 5-aminosalicylic acid or 5-ASA) can often effectively relieve signs and symptoms. Other common medications for ulcerative colitis include drugs that reduce inflammation by suppressing the immune system, such as prednisone, azathioprine, 6-mercaptopurine and infliximab. In severe cases of ulcerative colitis that don't respond to medical treatment, surgery is an option. Surgery usually involves removing the entire colon and creating an internal pouch that is connected to the anus. This allows the normal passage of stool through the rectum.

A considerable amount of research is examining inflammatory bowel disease. Results from this research will likely have an impact on the management of ulcerative colitis. For example, recently a large clinical trial that focused on Crohn's disease (another type of inflammatory bowel disease) found that a combination of two drugs -- infliximab plus azathioprine -- appeared to improve certain treatment outcomes in some people. Researchers hope that studies like this will further define optimal treatment strategies in ulcerative colitis, as well.

If you are interested in participating in a clinical research trial related to inflammatory bowel disease (ulcerative colitis or Crohn's disease), talk to your doctor about studies that may be available in your area. In addition, you can refer to several online resources for more information. Clinical trials available through the National Institutes of Health (NIH) are listed at www.clinicaltrials.gov. You can also search for clinical trials offered through Mayo Clinic at clinicaltrials.mayo.edu. The Crohn's and Colitis Foundation of America (www.ccfa.org) is another good source of information where you also can connect with other people and families dealing with inflammatory bowel disease.

Ulcerative colitis is a chronic condition that requires ongoing follow-up care. Typically, gastroenterologists and colorectal surgeons are the specialists who care for people with ulcerative colitis. With careful monitoring and management, signs and symptoms of ulcerative colitis can often be significantly reduced.

-- David Bruining, M.D., Gastroenterology, Mayo Clinic, Rochester, Minn.

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care.