Ulcerative colitis (UC) is a long-term disease that you may live with for decades. Most people have mild to moderate symptoms, but they can be unpredictable—flaring up first and then fading away. So, what can you expect in the future, and will you be able to better manage your symptoms?
Can UC go into remission?
Ulcerative colitis is what experts call a relapsing and remitting disease. This means symptoms will appear and disappear over time. There may be months or even years when you don’t experience any symptoms at all.
There is no single definition of what UC remission means. Your doctor may say it’s a balance between controlling symptoms and treating side effects. But a better overall quality of life may be most important to you, such as enjoying a symptom-free social life.
According to Ugo Iroku, MD, a board-certified gastroenterologist at New York Gastroenterology Associates, about half of U.S. UC patients are in remission, based on how they are measured. The other half had symptoms ranging from mild to severe.
Generally speaking, there are three types of UC remission:
- clinical remission. This is the most basic type of relief—no abdominal pain, diarrhea, or bloody stools.
- Endoscopic relief. If you have no symptoms and no inflammation in your gut, you may be in endoscopic remission. Your doctor will look for inflammation during a colonoscopy, which uses a tiny camera attached to a thin, flexible tube.
- Deep (histologic) remission. This is the most robust level of mitigation. Doctors will check for three things: No symptoms, inflammation or signs of UC at the cellular level under a microscope.
Does deep remission mean I’m cured?
Currently, the only treatment for UC is surgical removal of the colon and rectum. Even if you are in deep remission, you may still have a relapse in the future.
Being symptom-free for a long time may fool you into thinking you have fully recovered from UC.
“It’s human nature,” Iroku said. Being in remission allows you to go about your daily life with ease and stop managing your condition, he says.
“When people are in deep remission, sometimes they stop taking their medication. Unfortunately, your risk of flares increases. That’s a story we see a lot. The good thing is, there are usually things we can do to try and bring about [UC] Restoring control.
He reminds people with UC to talk to their doctor before stopping their medication.
What will happen to me if symptoms return?
It’s important to know your body when you have a long-term disease like UC, which has symptoms that come and go. Understand your situation and keep it on your radar. Maybe you have more bowel movements than usual or you have more pain. Other signs include:
- Diarrhea containing blood or pus
- stomach pain and cramps
- rectal pain or bleeding
- strong desire to defecate
- Difficulty defecating
- lose weight
- extreme fatigue
- fever
“These are early flashing red lights on the dashboard that should make you talk to a doctor,” Iroku said.
Factors that make the condition worse (certain foods or medications) may change over time. As you age, your body, including your gastrointestinal system, may become more sensitive to irritation.
You and your doctor can also work together to determine whether your symptoms are indeed a UC episode or another symptom, such as irritable bowel syndrome, infection, or medication side effects.
One of the best predictors of future UC flares is whether you have a UC flare now. If you have active ulcerative colitis this year, your chance of having it next year is about 70%. This also means that if you are in remission today, your chances of remaining symptom-free increase.
Quitting smoking, staying active, reducing stress, and avoiding trigger foods will help control symptoms for longer.
Effective medications are also critical to controlling flares. Long periods of relief can make it difficult for you and your doctor to know whether the medication is working. It may take a while to find ways to feel better. Even if you are not experiencing symptoms, it is important to see your doctor regularly and stay informed about the latest test results.
