Ulcerative Colitis Medications

Ulcerative colitis is a condition that results in inflammation and ulcers. Top that with the common symptoms of stomach pain and diarrhea with blood, and you’re in need of some serious pain relief. The main goal of working with your physician and finding the right type of medication that helps reduce pain and inflammation related to your condition-specific overactive immune system. Learn about some of the most common ulcerative colitis medications and what they do in your body.

Aminosalicylates (5-ASA)

Aminosalicylates (5-ASA) are specific medications that work on the lining of the gastrointestinal tract in order to decrease inflammation. These can help manage mild to moderate IBD. They can also be used for Crohn’s disease but are often more effective in ulcerative colitis.

-Sulfasalazine (Azulfidine)

-Mesalamine (Asacol HD, Pentasa, Lialda, Apriso, Delzicol)

-Olsalazine (Dipentum)

-Balsalazide (Colazal)


How do they work?

These are chemically similar to the over-the-counter pain reducer, aspirin. They decrease the inflammatory response, so damaged tissues can heal. These medications block your body from making prostaglandins, or on-off switches in your cells that regulate pain and inflammation. Recent research also suggests that they decrease damaging molecules (reactive oxygen species) in your body.



These are a powerful type of medicine, used to reduce inflammation. Also referred to as steroids, they can be used with or instead of 5-ASA to help treat a flare-up. Unlike 5-ASAs, corticosteroids are not used for long-term treatment. That’s because they have some side effects such as weakening the bones. They work by lowering the activity of your immune system and limiting inflammation in the digestive tract.

-Prednisolone (brand names Deltacortril, Deltastab, Dilacort)


-Hydrocortisone (Plenadren)

-Methylprednisolone (Medrone)

-Beclometasone dipropionate (Clipper)

-Budesonide (Entocort,Budenofalk)

-Budesonide-MMX (Cortiment)


How do they work?

Inflammation is a process in which your body “fights” against infection or foreign objects such as viruses. But if the immune system doesn’t work properly, it can cause inflammation and damage. Steroids reduce the amount of chemicals your body makes, which cause inflammation. They also reduce the activity of the immune system by interfering with the way that white blood cells (your body’s main “troops”) work.



These are medicines that help reduce the activity of the immune system. By suppressing the body’s immune system, it cannot cause repetitive inflammation and pain to your body. They’re usually given to treat moderate flare-ups or to maintain remission. They’re effective in treating ulcerative colitis but usually take about 2 to 3 months to start working. One thing to be aware of is that they can make you more vulnerable to an infection so it’s important to report any signs or signals of a sickness to your doctor.







How do they work?

As a normal immune response, your body flags harmful substances, such as viruses, so the next time it comes into your body, it will be prepared to attack and keep you safe. In autoimmune diseases such as colitis, your immune system mistakes healthy cells and tissue for these dangerous foreign objects. Immunosuppressive medications remove or slow down these overactive “troops” (such as C or T cells).


Biologic Medicines

These are medications used to reduce inflammation in the intestines. They are usually prescribed if other options aren’t working.






How do they work?

These medications reduce inflammation in the intestines by targeting proteins that your immune system uses to stimulate inflammation. They block the receptors (almost like blocking a key from unlocking a door) and tell your cells what to do. This way you don’t have as much inflammation “coming in the door”.



This newer medication works by targeting the immune system but differently than other medicines. It’s recommended for people with more severe ulcerative colitis and if the other treatment or biologics don’t work.

-Tofacitinib (Xeljanz)


How do they work?

Enzymes help speed up chemical reactions in your body. Tofacitinib works by interfering with a specific enzyme (janus kinase) which influences the inflammation. So it basically stops the message to turn on inflammation in your gut.


Over-the-Counter (OTC)

Over-the-counter drugs can be helpful in some cases since they don’t require a prescription. However, it’s very important to consult a physician before taking them, since they may interfere with other medications. Keep in mind that they may help decrease symptoms but don’t address the underlying reason.

Antidiarrheals help reduce diarrhea by decreasing bowel movement and by slowing the digestive process. An example would be Loperamide (Imodium).

Pain relievers work by making so you don’t feel pain, via receptors (which receive information), or by decreasing inflammation. However, it’s important to consider the type of pain reliever you use. These should not be taken when you experience ulcerative colitis pain since they can cause flare-ups and make some symptoms, such as diarrhea worse: ibuprofen (Advil, Motrin), aspirin (Bufferin), naproxen (Aleve, Naprosyn). Rather, it’s best to stick to acetaminophen.


Take Control of Your Condition

The goal of ulcerative colitis medication is to reduce inflammation and the immune response, in order to decrease flare-ups and symptoms. Different medications respond differently with each individual. Finding the right medication regime can take some time but it’s important to work with your physician and communicate any changes in how you feel and your daily symptoms. In addition to following your medication regime, improve your quality of life, including improving fatigue, pain, and anxiety, with the help of Nori Health.