Recent advances in gastroenterology have introduced new treatment options for digestive conditions that previously had limited effective therapies. Patients with conditions like ulcerative colitis often cycle through medications as treatments stop working, while fatty liver disease is managed almost entirely through diet and lifestyle changes. That landscape is beginning to shift as several medications approved over the past two years target the biological processes driving these conditions rather than just controlling symptoms. This shift offers new approaches for patients whose conditions haven’t responded to standard treatments.

Conditions That Have Been Difficult to Treat

Some digestive conditions have posed persistent challenges in gastroenterology because effective treatment options were limited or, in some cases, didn’t exist at all. Ulcerative colitis and fatty liver disease illustrate this problem in different ways. In ulcerative colitis, many patients struggle to find medications that provide lasting control, while fatty liver disease had no approved drug treatments until very recently. Both conditions can progress over time without effective intervention, leaving patients with few options to change the course of their disease.

Ulcerative colitis is one of the two primary forms of inflammatory bowel disease (IBD), a group of conditions marked by chronic inflammation of the gastrointestinal tract. In ulcerative colitis, inflammation affects the colon and rectum and can cause symptoms such as persistent diarrhea, bleeding, and abdominal pain. Many patients cycle through multiple medications as treatments stop working or lose effectiveness over time. Even biologics, which require regular injections, don’t work for everyone, and some patients become dependent on corticosteroids despite their side effects.

Fatty liver disease develops when excess fat accumulates in the liver, most often in people with obesity or diabetes. When inflammation and liver cell damage occur alongside fat buildup, the condition becomes nonalcoholic steatohepatitis (NASH), which can progress to liver scarring and cirrhosis. Until very recently, treatment consisted entirely of weight loss through diet and exercise. While beneficial, this approach is difficult for many patients to sustain at the level needed to prevent disease progression.

New Medication Options

Three medications approved between 2023 and 2025 address these treatment gaps through distinct mechanisms that work on the immune and metabolic processes underlying these diseases. Each offers approaches that weren’t previously available, providing options for patients whose conditions have been difficult to manage with existing therapies.

  • Etrasimod (Velsipity) for ulcerative colitis: Approved in October 2023, etrasimod is an oral medication that reduces inflammation by preventing immune cells from traveling to the gut lining. Unlike biologics that require regular injections, etrasimod is taken once daily as a pill. Clinical trials showed that roughly one-quarter of patients achieved remission, particularly those who hadn’t responded well to other treatments.1
  • Semaglutide (Wegovy) for fatty liver disease: Originally developed for diabetes and obesity, semaglutide received FDA approval in August 2025 specifically for treating NASH. The medication works by affecting metabolism and promoting weight loss, which in turn reduces liver fat and inflammation. Studies demonstrated that over 60% of patients achieved resolution of liver inflammation, representing substantial improvement in a condition that previously had no drug treatments.2
  • Resmetirom (Rezdiffra) for fatty liver disease: Approved in March 2024 as the first medication specifically for NASH, resmetirom targets liver metabolism directly to reduce fat accumulation and inflammation. The drug activates thyroid hormone pathways in the liver without affecting other organs, helping to break down liver fat and improve scarring. Clinical trials showed that roughly one-quarter of patients had measurable improvement in liver fibrosis after one year of treatment.3

    What This Means for Patients

    These medications are generally prescribed for patients whose conditions have been difficult to control with standard approaches rather than as first-line treatments. For ulcerative colitis, etrasimod is typically considered after patients have tried conventional therapies without achieving lasting remission. For fatty liver disease, both semaglutide and resmetirom require confirmation of NASH with liver fibrosis, often through biopsy or advanced imaging.

    While these drugs expand treatment options significantly, they work alongside rather than replacing comprehensive care. Patients taking these medications will still require regular follow-up with their gastroenterologist to track response and manage any side effects. Lifestyle management remains important, particularly for metabolic conditions like fatty liver disease where diet and exercise continue to support treatment effectiveness.

    As specialty medications, these treatments typically involve insurance review and prior authorization processes, and many pharmaceutical companies offer patient assistance programs to help with access. Despite these practical considerations, the availability of targeted therapies represents a meaningful shift for conditions that previously offered few effective medication options. For patients who have watched their disease progress despite standard treatments, having options that can modify disease course rather than just manage symptoms provides possibilities that didn’t exist even a few years ago.

    Contact Cary for Comprehensive Digestive Care

    The gastroenterologists at Cary Gastroenterology stay informed about advances in treatment options for digestive conditions, including recently approved medications for ulcerative colitis and fatty liver disease. If you’re dealing with a digestive condition that hasn’t responded well to standard treatments, our team can evaluate your situation and discuss whether newer therapeutic approaches might be appropriate. We provide comprehensive care that addresses both immediate symptom management and long-term disease control. Contact us today to request an appointment and learn more about treatment options for your digestive health needs.





    1https://www.hcplive.com/view/fda-approves-etrasimod-for-moderately-to-severely-active-ulcerative-colitis
    2    https://gi.org/journals-publications/ebgi/kwo_sep2025/
    3https://pubmed.ncbi.nlm.nih.gov/38324483/