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Ulcerative colitis causes inflammation and ulceration of the innermost lining of the colon and/or rectum. At The Jill Roberts Center for Inflammatory Bowel Disease at NewYork-Presbyterian/Weill Cornell Medical Center and the IBD Center at NewYork-Presbyterian/Columbia University Irving Medical Center, our ulcerative colitis specialists provide the latest research-based treatments to relieve symptoms and improve the quality of life of people with this inflammatory bowel disease (IBD).
Medications for ulcerative colitis
In addition to dietary and other lifestyle changes, a variety of medications are available to manage your ulcerative colitis symptoms and to help you achieve and maintain remission. Your doctor will choose the medications that are most appropriate for your care.
- Anti-inflammatory agents, such as aminosalicylates (like 5-ASA), are aspirin-like anti-inflammatory agents often used as the first drug therapy for people with early-stage ulcerative colitis.
- Antibiotics and probiotics are beneficial for relieving symptoms in some people with ulcerative colitis.
- Steroids such as prednisone are typically used to treat people with moderate to severe disease and reduce symptoms that have persisted despite other therapies. Because steroids do not maintain remission and have side effects, however, we discuss strategies with you to limit or avoid their use.
- Immunomodulators help to reduce inflammation and maintain remission by reducing the immune response, which is heightened in people with ulcerative colitis.
- Biologic therapies stop certain proteins from causing inflammation and have proven to be effective treatments for people with ulcerative colitis. You may receive infliximab (Remicade), vendolizumab (Entyvio), adalimumab (Humira), or golimumab (Simponi) in one of our modern and comfortable infusion suites, with experienced nurses monitoring your comfort during your treatment.
Minimally invasive ulcerative colitis surgery
When medications are not sufficient for controlling ulcerative colitis symptoms, surgery may be needed—typically a "proctocolectomy" to remove the entire colon and rectum. Since ulcerative colitis involves only the large bowel, this operation cures the disease. NewYork-Presbyterian’s exceptionally skilled colorectal surgeons use minimally invasive laparoscopy to perform this surgery whenever possible. You may then need:
- Ileostomy. The surgeon disconnects the end of the small intestine from the large intestine and then uses it to create an opening, or stoma, on the surface of the abdomen, through which waste is emptied into a bag. You’ll receive support and education from ostomy nurses specially trained in the care of people who need to wear an ostomy bag.
- Reconstructive ileoanal pouch procedure (ileoanal anastomosis or “J-pouch”). During this procedure, the surgeon creates an internal pouch from part of your small intestine to provide a storage place for stool in the absence of the large intestine, allowing avoid the need for an ostomy bag. Some studies suggest that fertility may be decreased after an ileoanal pouch procedure, possibly as a result of internal scarring. However, women of child-bearing age have spontaneously conceived and given birth successfully after this procedure. The laparoscopic techniques used by surgeons at NewYork-Presbyterian reduce the amount of internal scarring.
- Revision surgeries. Some people who had a J-pouch experience bowel function problems and require additional “revision” surgery, such as pouch salvage surgery or “continent ileostomy” (K-pouch) procedures. Our surgeons have extensive experience in these techniques, which may allow for preservation of the anal sphincter, bowel function, and quality of life.
Fecal transplants for ulcerative colitis
Clostridium difficile (C. difficile) is a common bacterium that can cause infection in the intestines. NewYork-Presbyterian researchers are evaluating fecal transplant, a novel approach to treating people with ulcerative colitis who have C. difficile, which may also prove useful for patients with ulcerative colitis who don't have this infection. Studies have shown that introducing bacteria from the stool of a healthy individual into the intestines of someone with ulcerative colitis and C. difficile can restore the normal diversity of “friendly” intestinal bacteria, relieving colitis symptoms and even curing the disease in some patients. This approach shows great promise and requires further evaluation in clinical trials to see if it can be used to effectively treat inflammatory bowel disease.
Clinical trials for ulcerative colitis
NewYork-Presbyterian investigators are conducting clinical trials to assess innovative therapies for ulcerative colitis. You may have the opportunity to participate in a clinical study evaluating a promising new treatment. If you are interested in learning more about current trials at NewYork-Presbyterian and other facilities across the nation, visit our Clinical Trials section.