Ulcerative colitis is a relapsing-remitting inflammatory-bowel disease confined to the colon and rectum, characterised by continuous mucosal inflammation. Like Crohn's, treatment targets remission induction and maintenance through immune suppression. Biologic therapies and emerging cell therapies offer improved outcomes.
5-aminosalicylates (mesalamine, sulphasalazine) are first-line for mild-to-moderate disease and remission maintenance. Topical formulations (enemas, suppositories) deliver high drug concentration. Corticosteroids induce remission but are reserved for severe exacerbations. Immunosuppressants (azathioprine, 6-mercaptopurine) reduce steroid dependence. TNF-alpha inhibitors (infliximab, adalimumab) induce remission in 40–50% of patients. Vedolizumab targets gut-homing integrins with excellent colitis-specific efficacy. Tofacitinib, a JAK inhibitor, is newly approved and oral. Proctocolectomy (surgical removal of colon and rectum) is curative but irreversible; ileal-pouch-anal anastomosis (IPAA) preserves continence.
Exclusive enteral nutrition shows modest benefit in ulcerative colitis (less dramatic than Crohn's). Low-residue, low-fat diets reduce symptoms during flares. Herbal agents (curcumin, boswellia) and fish-oil supplementation show weak anti-inflammatory effects. Prebiotics and probiotics are explored but lack strong evidence.
Mesenchymal stem cells and faecal microbiota transplantation are being studied for mucosal healing and barrier restoration. Stem cells promote epithelial-cell regeneration and reduce TNF-driven inflammation. Autologous stem-cell therapy is under investigation in several European centres. These remain investigational and should accompany biologic therapy. See candidacy criteria for eligibility.
| Option | Type | Evidence | Indicative cost | Invasiveness | Recovery |
|---|---|---|---|---|---|
| 5-aminosalicylate (mesalamine, sulphasalazine) | Standard | Strong | €600–1,200/year | Low | None |
| TNF-alpha inhibitor (infliximab, adalimumab) | Standard | Strong | €8,000–15,000/year | Low | None |
| Vedolizumab | Standard | Strong | €9,000–17,000/year | Low | None |
| Tofacitinib (JAK inhibitor) | Standard | Strong | €7,000–14,000/year | Low | None |
| Low-residue diet + fish-oil supplementation | Alternative | Moderate | €300–700/year | Low | None |
| Faecal microbiota transplantation (FMT) | Regenerative | Moderate | €3,000–6,000 | Medium | 1–2 weeks |
| Mesenchymal stem-cell mucosal healing | Regenerative | Investigational | €14,000–30,000 (trial-dependent) | Medium | 2–3 weeks |
Yes. UC is confined to the colon; Crohn's affects any GI site. UC inflammation is superficial; Crohn's is transmural. Both require similar biologic therapy, but UC is curable by proctocolectomy.
Early trials show mesenchymal stem cells may enhance epithelial regeneration and reduce inflammation, but long-term remission rates are not yet superior to biologics.
The colon is removed and the small intestine is reconnected to the anus (IPAA). Most patients have 4–6 bowel movements daily and preserve continence. UC is cured, but pouchitis (inflammation of the pouch) may occur.
We link primary regulators, registries and peer-reviewed research so you can verify everything yourself — plus the treating clinic's own materials.
Educational overview of treatment options; not medical advice. Standard treatments reflect mainstream guidance; regenerative/stem-cell uses are largely investigational. Reviewed by the StemCellAtlas editorial team.
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