Ulcerative Colitis Patients Reminded to Continue Treatment Despite Lacking Symptoms
Patients managing ulcerative colitis who no longer experience noticeable symptoms must continue taking their prescribed medication to maintain disease control, Mayo Clinic reported. Stopping treatment typically causes symptoms to return for the majority of individuals, as the chronic condition currently lacks a cure.
Sunanda V. Kane, M.D., a gastroenterologist at Mayo Clinic in Rochester, Minnesota, and co-author of “Mayo Clinic on Crohn’s Disease & Ulcerative Colitis,” compared managing ulcerative colitis to treating type 1 diabetes with insulin. Although insulin successfully manages the disease and prevents complications, it does not cure the underlying condition because the pancreas still produces little to no insulin on its own.
“If you go on insulin to treat your diabetes and your blood sugars are now under good control, you don’t stop the insulin. It’s what got you under control,” Dr. Kane stated.
Inflammation Continues Beneath the Surface During Remission
Remission in ulcerative colitis means the disease is well-controlled, but healthcare professionals evaluate both patient-reported symptoms and objective signs of inflammation to measure treatment success. Patients often feel well and see their day-to-day activities unaffected, yet active inflammation may still persist inside the digestive tract.
Healthcare providers assess clinical features through objective diagnostic tests, including endoscopies like colonoscopies to inspect the lining of the colon and rectum. Physicians also examine tissue samples under a microscope in a process called histology. Individuals may feel completely symptom-free while still failing to achieve endoscopic or histological remission, meaning microscopic inflammation remains active.
Risks Associated With Discontinuing Medication
Maintenance therapy keeps ulcerative colitis under control and lowers the long-term risk of symptom relapse. Patients who stop taking their medications experience a faster return of symptoms compared to those who maintain their regimens, with the risk of early relapse increasing for individuals who previously took long courses of steroids.
Abruptly stopping treatment can trigger severe flare-ups requiring hospitalization, steroid treatments, or surgery. Aminosalicylates, or 5-ASAs, serve as a common anti-inflammatory treatment for mild ulcerative colitis and help reduce the risk of colorectal cancer when taken over a long period. While stopping medication is not recommended, Dr. Kane noted that some clinical situations may warrant lowering a drug dosage or taking it less frequently after consulting a care team.
Monitoring Disease Activity and Inflammation
Medical teams track ulcerative colitis during remission using blood tests, stool tests, ultrasound examinations, endoscopic procedures, and routine office visits. Ultrasound exams and stool studies evaluate inflammation without requiring invasive procedures.
Endoscopic procedures require specialized dietary preparation, laxatives, and medication adjustments before an instrument is inserted into the bowel. Patients uncertain about monitoring options discuss their preferences with healthcare teams to determine the best tracking methods.
Frequently Asked Questions About Ulcerative Colitis Remission
What is the only permanent cure for ulcerative colitis?
The only current way to cure ulcerative colitis is a proctocolectomy, a surgical procedure that involves removing the entire colon and rectum.
Can other conditions mimic ulcerative colitis symptoms during remission?
Yes, patients experiencing gastrointestinal symptoms during remission may actually be dealing with overlapping irritable bowel syndrome, medication side effects, or a separate infection.
Do doctors recommend any adjustments to treatment without stopping it entirely?
Dr. Kane noted that healthcare professionals may occasionally lower a medication dosage or reduce how often a patient takes it, provided the patient consults their care team first.
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