Patient's Query
Hello doctor,
I am a 41-year-old woman diagnosed with ulcerative colitis in my early 20s. For many years, my symptoms were manageable, but recently, they have become much harder to control flare-ups.
Why is ulcerative colitis harder to control after the age of 35?
Does the disease naturally change as we get older?
Could hormonal changes, stress, or long-term use of medications affect how my body responds to treatment now?
I am concerned because the medicines that once worked well do not seem as effective anymore.
Please help.
Thank you.
Hello,
Welcome to icliniq.com
It is understandable to worry when ulcerative colitis seems harder to control after many stable years. In most cases, this change is not simply due to age, but rather due to how the disease and the immune system behave over time.
Ulcerative colitis is a long-term immune-related condition. The immune system may become more active or less responsive to certain medicines after many years. This can happen because inflammation slowly changes the inner lining of the intestine or because the body does not respond to treatment in the same way as before.
Several factors may contribute:
1. Immune adaptation: Over time, the immune system may stop responding well to earlier treatments such as Mesalamine or other immunosuppressant medicines. In such cases, stronger or different medicines may be needed.
2. Repeated inflammation over the years: Frequent flare-ups can make the colon more sensitive, so symptoms may return more easily than before.
3. Hormonal and body changes: Hormonal changes in the late 30s and 40s can affect the immune system and the gut in some women, which may make flare-ups harder to control.
4. Stress and lifestyle factors: Stress affects the connection between the brain and the gut. This can trigger symptoms even when medicines are being taken regularly.
5. Reduced response to medicines: Sometimes the body becomes less responsive to certain drugs, especially long-term treatments or biologic medicines. In such cases, doctors may change therapy to medicines like Infliximab, Vedolizumab, or Ustekinumab, which work in different ways on the immune system.
Doctors may also suggest tests such as fecal calprotectin, blood tests, or a colonoscopy to see whether symptoms are due to active inflammation or other problems like irritable bowel syndrome overlap.
Ulcerative colitis does not always get worse because of age alone. However, the disease pattern and immune response can change over time, so treatment may need adjustment. With proper monitoring and newer medicines, many people can regain good control even after symptoms become harder to manage.
Kindly revert if there are any queries.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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