Treatment of ulcerative colitis: medications or surgery? Which one to choose?

Treatment is aimed at influencing the course of the disease and its role is to ensure a long remission of symptoms.

Conservative treatment is chosen, which is also referred to as maintenance treatment to maintain remission. And acute treatment is to guarantee rapid onset of remission in relapse.

5-aminosalicylic acid derivatives, mesalazine, are used for this. Glucocorticoids are used in the more severe form. Immunomodulators, cyclosporine A or biological therapy for immunosuppression are also used. 

Further, suppositories and enemas are used, especially in the case of affection of the rectum and lower intestine. Probiotics are a suitable complement.

Surgical treatment is mainly chosen in case of acute stage with severe course. Especially with megacolon and perforation of the intestine, massive bleeding, but also if the medical approach fails.

Similarly, a bowel tumour, which can be a serious complication, is surgically removed.

In case of severe course, the solution is total colectomy, or even total proctocolectomy, with ileostomy and rectal closure. Or a connection of the small intestine with the rest of the rectum is made.

However, this method limits a person's standard of living. The stool is emptied more often during the day and is sparse. And a complication is also frequent inflammation of the formed connection. 

In the framework of the disease, adherence to regimen measures, diet, maintaining a drinking regime is advisable. Sunbathing is mentioned as advisable, but especially for the formation of vitamin D, which is important for the functioning of the organism. In the winter period, it should be supplemented in the form of dietary supplements.

Diet is not as important as in Crohn's disease. But in general, a rational diet that represents all the necessary food components, minerals and vitamins is best.

Of course, excessive intake of refined sugar is inappropriate. A reduction in caffeine intake is necessary.

It is important to trace food allergies, such as lactose intolerance, and therefore limit the consumption of dairy products and milk. 

Psychotherapy and stress reduction are also of great importance.