Hello all! I’m at a crossroads in my fight against UC.
For context: I was formally diagnosed with UC after a colonoscopy in late February 2026 after a few months of a pretty rough flare, which I was able to get the flare in check (mostly) with Mesalamine suppositories and a Budesonide foam. Still took about 2 months to fully clear up.
After the colonoscopy, I was prescribed 4800mg Mesalamine oral. Almost immediately upon starting the oral Mesalamine, my symptoms vanished. No more bleeding, no more diarrhea, etc. I also maintained the suppository, but ended up switching to the Mesalamine enema later on. Currently I do 4800mg oral in the morning and an enema at night.
Anyway, I went in for my 6 month follow-up colonoscopy last week. My GI found that I am in clinical remission (no symptoms) but NOT in endoscopic remission, so I am still at a higher risk for colon cancer and future flares. There is still inconsistent inflammation in my Sigmoid and other areas. He said that I’m still at a Mayo 1 diagnosis based off the lab work.
He suggested switching from Mesalamine to Velsipity (etrasimod) or Entyvio (vedolizumab). It makes me somewhat anxious to do this when I really don’t feel that my body has failed Mesalamine, because I’ve had <5 incidents of bloody stool or any UC-related symptoms in the 6 months I’ve been on the Mesalamine combo. That being said, the biopsies came back consistent with Mayo 1 and minor inflammation, so I don’t want to increase my long term cancer risk.
Another factor is that I am active duty military. Velsipity is an “ok” in the eyes of the military, but Entyvio has the potential to make me non-deployable and potentially face a Med board. I’m not quite ready to exit the military, but from the research that I’ve done, Entyvio seems to be safer and more effective at treating UC.
I just wanted to see if anyone else has been in a similar circumstance, or has any insight to this problem. Should I get a second opinion? Not really sure what to do…thank you all in advance!