Uc prognosis is wildly unpredictable, especially within the first 5-years of diagnosis. Some of us have a mild-mannered case of UC that is little trouble (only infrequent and mild flares), and responds to the mildest mesalamines indefinitely. Some of us have more troublesome cases that flare moderate/severely within a year or two or less, and due to disease progression require stronger medications going forward. Some of us have difficult cases that do not respond to anything, we quickly escalate up the UC ladder and surgery quickly finds us (about
25% of cases). Much like a game of poker, nobody knows who has the winning hand at the start, we all hope for the best!
Best you can do is be cautiously optimistic. However, remain mindful of any signs of regression back into a flare. UC is a disease known for periods of remissions and periods of flares, so we all do flare eventually. Not a matter of "if," but rather a matter of "when." And to that end, catch it early when it's a small problem rather than ignore a flare and let it get much worse (much easier to put out a smoldering ember than to put out a 5-alarm house fire).
Generally speaking (there's always outliers, but the majority of), proctitis patients have an easier course of UC than those of us with more extensive involvement.
I'm a fan of statistics and odds, so lets throw some at it:
Odds of remission and varying degrees of flares Ulcerative colitis patients in a given year:
- 48% of people with ulcerative colitis are in remission
- 30% have mild disease activity
- 20% have moderate disease activity
- 1% to 2% have severe disease
70 percent of patients who have active disease in a given year will have another episode of active disease in the following year.
Only 30% of those in remission in a given year will have active disease in the following year. The longer a person with ulcerative colitis remains in remission, the less likely he or she is to experience a flare-up of the disease in the following year."
Source: http://www.ccfa.org/resources/facts-about
-inflammatory.html
Odds based on initial disease extent - On average, individuals with ulcerative colitis have a 50% chance of having their next flare within 2 years (Rowe).
- The majority of individuals who advance to more extensive disease will do so within the first 5 years after diagnosis (Rowe).
- If ulcerative colitis is initially limited to the rectum at the time of diagnosis (a proctitis), fewer than 30% of individuals will go on to develop more extensive disease (Rowe). Approximately 10% of patients presenting with proctitis will develop a pancolitis (Rowe). The disease remains confined to the rectum in approximately 25% of cases (Rowe).
- If ulcerative colitis involves the rectum and sigmoid colon, there is a 50% chance of more extensive disease progression over 10 years; for these individuals, the rate of complete or partial surgical removal of the colon (colectomy) is 12% over 25 years (Rowe).
- Pancolitis occurs in 10% of patients (Rowe).
- Individuals with ulcerative colitis have an increased risk of developing colorectal cancer at a rate of 0.5% to 1% per year (Le); overall, cancer occurs in 3% to 5% of individuals (Khan).
- Extraintestinal complications occur in approximately 20-25% of patients with IBD (Rowe).
Source: http://www.mdguidelines.com/ulcerative-colitis