5-ASA not only helps to settle the acute inflammation but taken on a long term basis tends to keep the inflammation inactive. Oral corticosteroids such as prednisone, have a significant role to play but are usually reserved for more serious exacerbations of ulcerative colitis. Prednisone is a potent inhibitor of inflammation but does have side effects that need to be weighed against its benefit. This means its side effects are substantially less than prednisone. Again, there are also side effects that must be assessed.
Some antibiotics can be effective in treating ulcerative colitis.
Their mechanism of action is unknown. In patients with ongoing active disease that fails to respond to all forms of management, surgery may be indicated. If surgery is necessary, the whole colon usually must be removed. In most of these patients, the anus can be spared and a pouch can be created from the small bowel. In these cases, bowel movements can pass through the anus rather than necessitating an ileostomy.