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IBD – Ulcerative Colitis

“IBD is much more manageable than 20 years ago. The medications we have today allow patients to enjoy an excellent quality of life.”

Dr. Christopher Hurley

Ulcerative colitis is an inflammatory bowel disease caused by an abnormal immune response to harmless bacteria in the digestive tract. The result is inflammation, thickening of the intestinal wall and ulceration. Ulcerative colitis affects the colon and mucosa, the surface tissue layer of the colon. Cases range from mild to life threatening, and patients are more prone to developing colorectal cancer.

Blood work, stool studies, colonoscopy and radiology/imaging strategies are used in diagnosis. Biopsies taken during a colonoscopy can be studied for dysplasia. Computed tomographic enterography (CTE) and magnetic resonance enterography (MRE) are two imaging tools that provide a thorough view of the abdomen to allow the physician a full evaluation.

Treatment plans for ulcerative colitis are individualized for each patient. If ulcerative colitis can be controlled by medication, treatment strategies may include:

  • Step-up approach – Using less strong medication and then stepping up to stronger medication
  • Top-down approach – Using stronger medications to attack inflammation, and then moving to less potent medications
  • Aminosalicylates – Long-term medication that reduces inflammation
  • Corticosteroids – Available orally or rectally, a short-term medication that treats moderate to severe disease
  • Immunomodulators – Suppresses immune system response to prevent further inflammation
  • Antibiotics – Used when abscesses or infections are present
  • Biologic therapies – Antibodies attach to tumor necrosis factor agents, allowing the body to destroy these chemicals and reduce inflammation

If ulcerative colitis cannot be controlled by medicine, patients may undergo minimally invasive surgery, including:

  • Laparoscopy – Resects the inflamed portion of the bowel back together, allowing patients to recover faster with less pain
  • Strictureplasty – Opens a narrowed section of the bowel by making a longitude cut and closing it transversely