This type of inflammatory bowel disease can change over time, which means your treatment strategy and management plan may need some adjustment along the way.

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD). It’s marked by inflammation in the lining of the large intestine, which can lead to symptoms such as abdominal cramping, bowel urgency, and diarrhea.

These symptoms may go through periods of inactivity, known as remission, and times of active symptoms, or flares.

While UC can happen at any age, most people start developing symptoms in or before their 30s.

Even though remission may last years, there’s no cure for UC; it requires lifelong management. Medications and standard treatments can help, but managing UC over time also means learning how to adapt to changing needs.

These strategies can help.

When you live with a chronic condition like UC, keeping a daily log can help you gain insights about symptom patterns, possible triggers, and subtle changes that might otherwise be missed.

UC can progress over time, and experiencing more frequent symptom flare-ups may be a sign your medications need an adjustment, your dosing schedule needs an update, or a new therapy should be introduced.

It’s possible to go for extended periods of time, even years, without any changes in UC symptoms. This can make visiting the doctor feel unnecessary. But keeping regular appointments with your doctor allows you to continually monitor the progression of UC and optimize your treatment.

Changes in your gastrointestinal (GI) tract can occur even without noticeable symptoms. Signs of active or recurring disease may appear in follow-up lab work, stool testing, or imaging even when you’re in remission.

Medications must also be monitored regularly. Your doctor will review how well your current regimen is working and make changes to optimize treatment as needed. You’ll need to go over any new medications that may be added and how they may interact with current treatments.

Your doctor will also monitor for side effects like liver or kidney damage or perform annual skin checks if you’re taking a biologic drug.

Catching these types of changes to your condition early can improve the chances of effective UC management.

Monitoring for other health conditions related to UC is an important part of management throughout the years. UC progression can vary significantly from person to person. It doesn’t have a straightforward path of advancement, which makes it unpredictable.

UC can eventually lead to complications such as:

  • anemia, or a low red blood cell count
  • low bone mass
  • colorectal cancer
  • toxic megacolon, or inflammation in the large intestine that prevents it from functioning
  • severe rectal bleeding
  • large intestine perforation, or a hole in the wall of the intestine

In some people, these complications of UC occur quickly. For others, it may take years, or complications may never develop at all. If complications do occur, your UC management plan may require significant changes to address additional symptoms and reduce disease activity.

Seek emergency medical care if you start to experience symptoms of UC complications, such as:

  • high fever
  • persistent pain
  • severe, constant diarrhea
  • rectal bleeding with clots of blood in your stool

You may not be able to prevent UC flares, but staying on top of healthy lifestyle choices can help reduce the frequency of flares over time. These tips can help:

  • Eat a nutritious diet to help prevent malnutrition and dehydration, serious side effects of UC resulting from impaired nutrient absorption in the large intestine.
  • Exercise regularly to help reduce stress, maintain bone health, and improve immunity.
  • Manage stress to help limit how significantly your body’s stress response affects processes related to digestion, like slowed gut motility, which may make UC symptoms worse.
  • Prioritize quality sleep as UC can lead to sleep disturbances, and sleep disruptions may be linked to poorer UC outcomes.

Through the years, age-related concerns in UC, like increased risk of infection, may require adjusting your usual routine.

It might be necessary as an older adult to practice more extensive infection prevention, like:

  • wearing a mask
  • washing hands more frequently
  • receiving vaccinations for preventable infections like pneumonia

This is because people living with UC are considered to be immunocompromised. And if you’re also taking an immunosuppressant, that makes it even harder to fight off an infection, or if you do get sick, you may develop more serious infection-related complications.

People with UC tend to have lower bone density than those who aren’t living with the condition. Once you reach age 50, your doctor will likely also recommend regular screenings for osteoporosis.

Over time, life with a chronic condition can take a toll on your physical and mental health. Support groups offer a way to connect with people who share similar experiences.

Support groups allow for you to learn from others’ experiences, share your own insights, and cultivate a positive outlook regarding life with UC. They provide a sense of camaraderie, community, and understanding.

Advocate for yourself. Even if you have an excellent relationship with your doctor, no one knows what’s going on with your health like you do. So be sure to speak up and advocate for yourself and every visit.

And you don’t have to wait for appointments to check in. It’s OK to call the office and ask for a note to be added to your chart or to run a question by your doctor.

Keeping the lines of communication open helps you manage UC as effectively as possible through the years.

UC is a lifelong condition, and your treatment and management strategy may vary over time. But being proactive about lifestyle choices, doctor communication, and disease monitoring can help keep your symptoms under control, regardless of how long you’ve been living with the condition.