Can I expect remission with my IBD?

The aim with any case of inflammatory bowel disease (IBD) is to achieve remission.

What is remission?

Remission can be defined in a number of ways:

• Clinical remission: absence of symptoms (diarrhoea, abdominal pain, joint pain, fatigue, etc).
• Endoscopic remission: absence of active inflammation at endoscopy/colonoscopy.
• Radiologic remission: absence of active inflammation on imaging (MRI, CT, Ultrasound).
• Biochemical remission: normalisation of inflammatory markers on blood and/or stool tests.

What kind of remission should we target?

Clinical remission is important as we want our patients to feel well. Unfortunately, some patients can feel well and achieve clinical remission, but they may not have yet healed their bowel and achieved endoscopic or radiologic remission. Despite having clinical remission, if a patient still have active disease on endoscopic or radiologic investigations they are higher risk for needing bowel surgery and hospital admissions for disease flares.

Therefore, to the aim is to achieve and maintain more than just clinical remission for your your IBD. When your gut is healed on endoscopy and/or imaging over a period of time, we call this deep remission.

How is deep remission achieved?

Making sure that you are on the most appropriate and effective medication

As each patient is different it can be trial and error to find the right treatment for their particular disease. This is determined by the type of disease (Crohn’s Disease or Ulcerative Colitis), where the disease is (which part or how much of the bowel is affected), and how severe the disease is.

Regular testing

Regular blood and/or stool tests, colonoscopies, and imaging are important to ensure the inflammation  has been completely treated. If there is still active inflammation despite medical treatment, your treatment regime can be modified to ensure you are given the best chance of achieving deep remission.

Please ask our IBD team about any questions or concerns that you have about your medications to see if you are on the best treatment possible.

Contributed by Dr Paul Spizzo