UC Relapses
UC is a chronic gastrointestinal illness that follows a course of relapsing and remitting disease. Perhaps one of the most frustrating aspects of UC for patients is the abrupt onset and unpredictability of disease flares. A recent study suggested that the risk of relapse in UC is 40%, 57%, and 67%, at 2, 5, and 10 years, respectively. While there is no crystal ball to forewarn individuals when the next flare may arise, investigators have identified some factors which may be associated with a greater risk of relapse:
1) Relapse within the first year of diagnosis. Early relapse, defined as a disease flare within the first year of diagnosis, has been associated with having a greater number flares in the future. It is thought that early disease recurrence may suggest a more severe form of disease that requires aggressive treatment.
2) Younger age at diagnosis. Individuals diagnosed with UC under the age of 30 years may be at risk for earlier and more frequent flares. The reason for this is unknown, but may be related to genetic predisposition or constitution of the immune system.
3) Cessation of cigarette smoking. In a subset of patients with UC who are smokers, stopping smoking is associated with disease onset. Similarly, there is evidence to suggest that cessation of smoking in this group may increase disease flares. Such individuals also appear to have a higher risk of disease relapse then never smokers.
4) Not taking medication as prescribed. Studies have shown that up to 60% of UC patients admit to not taking their medication regularly (taking < 70% of prescribed medication). These individuals are 5 times more likely to have a disease flare than someone who is adherent to their prescription instructions.