Remission of inflammatory diseases

June 17, 2020


What does remission of inflammatory diseases mean?

Multiple sclerosis, rheumatoid arthritis or inflammatory bowel disease (IBD) are pathologies with shared characteristics. One of them is that we are talking about incurable diseases that occur with periods of outbreaks and others of remission. Meaning that one of their main characteristics is that the patient will go through periods of relapse when his disease will be active and others when the symptoms will improve or decrease significantly. Thus, the remission in inflammatory diseases, such as IBD, means that the pathology exists, but that that there are no symptoms.

Concretely, the Inflammatory Bowel Disease manifests with the appearance of intestinal symptoms like diarrhea, stool mixed with blood and abdominal pain. It can also present extra-intestinal symptoms such as fatigue, weight loss and joint pain. This picture will appear during a period of “outbreak”. This, also called “exacerbation” or “recidivism”, is defined as the combination of symptoms referred by the patient or objectified by a doctor of an inflammatory event. An outbreak must last, at least, 24 hours and occur in the absence of fiver or infection. The interval between two different outbreaks may not be less than one month. A sharp worsening of a previous deficit is also considered an outbreak. 

Remission of inflammatory diseases: When there is no trace of IBD 

Remission in inflammatory diseases is a state in which symptoms are under control. This allows the patient to maintain a good quality of life, as nothing will interfere negatively with his routine. In other words, problems such as having to go to the bathroom frequently disappear temporarily, an issue faced by patients with Crohn’s disease and ulcerative colitis and which limits and affects them in the development of their daily work activities, leisure, family and social relations. 

Talking about remission is possible thanks to the appearance of   pharmacological therapies. These medications focus on achieving and maintaining the remission of the disease.  At the same time, they prevent complications and normalize patients’ quality of life. However, the latter has a great responsibility in terms of adherence. Lack of adherence to treatment has been proven to be a significant predictor of relapse. Thus, in patients with IBD in remission who do not comply with treatment, the likelihood of regression increases more than 5 times compared to those who do so. 

Treatments to improve inflammatory diseases’ remission.

There are two types of treatments for IBD: the treatment to control symptoms during outbreaks and the maintenance treatment during remission to prolong the inactivity of the inflammatory disease. Taking the drugs and following the health recommendations helps to improve the symptoms to the point of almost making them disappear. 
Nevertheless, it is estimated that only half of the patients are fully adherent to treatment. This, possibly, happens because the absence of symptoms makes the person in question to forget his illness and relax. In fact, one of the most common questions doctors face is whether to stop or reduce the dose once remission in IBD is achieved. This is the main factor in the occurrence of regression. Therefore, improving adherence to treatment has become a major challenge when effectively dealing with IBD. 
The decision to withdraw a drug should be made individually and always by consensus between doctor and patient, based on patient preferences, disease markers and taking into account possible relapses.

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