Ulcerative Colitis: Managing Flares and Remissions
A continuous inflammation limited to the colon.
Dr. Yann Beaumont
Gastroenterologist
Bloody diarrhoea with mucus, urgency, tenesmus, and lower abdominal pain. Severity ranges from proctitis to extensive colitis.
Treatment
- 5-ASA agents (mesalazine) for mild-moderate disease
- Steroids for acute flares
- Thiopurines, anti-TNF, vedolizumab, JAK inhibitors for refractory disease
- Colectomy in severe or steroid-dependent cases
Cancer surveillance
Long-standing extensive UC raises colon cancer risk; surveillance colonoscopy every 1-3 years after 8-10 years of disease.
Lifestyle
Unlike Crohn's, smoking may transiently mask UC, but is never recommended given overall harm.
Symptom improvement does not always equal mucosal healing: regular endoscopic reassessment matters.
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