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What really is "remission?"

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Ulcerative Colitis
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Posted 6/22/2014 7:13 PM (GMT 0)
Hi everyone. I am new to the UC forum. I was officially diagnosed with UC in February of this year. I believe I have a mild form of UC but I am not sure what "remission" really is. Does this mean that ALL UC symptoms go away for some time? I am in the process of changing GI docs since he does not know how to answer all of my questions... If anyone could give me some insight, it would be helpful! Thanks! :-)
Posted 6/22/2014 7:21 PM (GMT 0)
Remission of symptoms used to be the target. Now the target for many GIs is endoscopic and microscopic remission which is a higher standard. That would be no evidence of disease activity by colonscopy or biopsy.
Posted 6/22/2014 10:45 PM (GMT 0)
Remission, as I understand it, is when your stools look like they used to, without mucus, and blood and your going to the bathroom a couple of times a day, rather than every couple of hours..but as AZYooper states you would need to have a colonoscopy to support this.
Posted 6/23/2014 1:22 AM (GMT 0)
My definition is if you aren't normal then you're not in remission, I could care less if the doctors were to try telling me I was in "clinical remission".
Posted 6/23/2014 4:02 AM (GMT 0)
If your completely symptom-free then your in "Clinical Remission".

If your symptom-free AND have also had a Colonoscopy to show that there is no signs of the disease, then your in "Endoscopic Remission".

Its possible to be symptom free, yet still show visible signs of the disease upon endoscopic examination, which is why endoscopic remission should be your goal.
Posted 6/23/2014 2:44 PM (GMT 0)
Can I jump in and ask a question?....If your symptom free, but then during a colonoscopy its found that there are still signs of disease, does this mean that your meds were never quite strong enough? and does this happen often?
Posted 6/23/2014 6:39 PM (GMT 0)
Poppie, I would figure the short answer to that is yes, meds weren't strong enough. But whether or not to increase meds may be more complicated. If the current treatment was maintenance dose 5ASA, then I would figure that it would be wise to increase, but if the 5ASA meds are already "maxed out", this is where it gets tricky, deciding whether or not to take the "big guns" just for mild signs. Balancing the risks. Really a question best answered by the GI.

I think it must be common enough if when you see the GI and say your symptom free, they still insist to arrange a scope to see.
Posted 6/23/2014 7:10 PM (GMT 0)
The new thinking is that just being symptom free is not good enough. Not all doctors agree with this. Personally if I were doing well symptom wise and happened to have some inflammation during a colonscopy I would not agree to going on steroids to nip it in the bud. There are doctors that believe in doing this and a recent study shows that this is beneficial for long term outcome if you go heavy right after diagnosis. I do not think there is evidence to support on going management by taking peeks and tweaking meds. Colonoscopies are a snap shot and I am not interested in having them all the time. I don't think the big gun approach will work without several per year. A profitable approach for the doctor which is a major bias to judgement.

Quality of life and cancer risk are my concerns and I think the overall evidence shows that people that are symptom free have little or no elevated risk of cancer. People with left side probably have none if their disease his well controlled symptom wise.

If I had a colonscopy that showed inflammation I would be OK with increasing 5asas or using rectals all the time. I think these drugs are extremely safe.
Posted 6/23/2014 7:17 PM (GMT 0)
I think it's when you don't have any active inflammation and your BM #, consistency and yadda yadda, are all as if you don't have UC.
Posted 6/23/2014 7:28 PM (GMT 0)
".If your symptom free, but then during a colonoscopy its found that there are still signs of disease, does this mean that your meds were never quite strong enough? and does this happen often?"


To specifically answer this. You really don't know the answers because the colonscopy is only a snap shot and you are going to have inflammation at some point even if a drug works great on you. I had very mild inflammation the last time and the doctor was not concerned at all. No med change was recommended. I assume it happens all the time.
Posted 6/24/2014 1:03 AM (GMT 0)
Thank you..
Posted 6/25/2014 7:34 PM (GMT 0)
Thank you all for your feedback. It seems then, that I am not in remission but have minimal symptoms. Thus, I have changed my Delzicol to Lialda and trying some Canasa suppositories at night. Also adding VSL #3. I am excited to try these new things.. Hopefully they help!
Posted 6/26/2014 10:32 AM (GMT 0)
Thanks for all of the posts. I am new to the site, but was diagnosed with proctitis in 2007. I used canasa at that time and my symptoms cleared. But, in the last couple months i have been in a flare and it is a challenge. I am trying to do the specific carb diet. I am trying to stay off the meds. I am so thankful that i have a job where i can work at home. I have had to for 2 days this week. Does anyone else ever feel like a prisoner to his or her bathroom?
I wasnt aware of the differences in remission, very helpful info. Thanks!

Post Edited (kat s.) : 6/26/2014 4:35:09 AM (GMT-6)

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