Secondary prevention

Almost all patients with ulcerative colitis (UC) require active maintenance therapy to prevent relapses. Except for corticosteroids, most therapies indicated in acute attacks can be used to maintain remission and prevent relapses, depending on disease severity and extent.

There is some evidence that aminosalicylates have chemoprotective effect against colorectal cancer in patients with UC.

Due to the immunosuppressive effect of many of the treatments of inflammatory bowel disease (IBD), there is now a growing awareness of the need for screening and vaccination, ideally at diagnosis.[142]​ Patients with UC should be immunised according to vaccine recommendations for patients with chronic diseases or altered immunity as a result of therapy.[144] All patients with IBD should be considered for the following five vaccinations: 1) influenza (trivalent) inactivated vaccine annually, 2) pneumococcal polysaccharide vaccine, 3) hepatitis B vaccine in all hepatitis B virus seronegative patients, 4) human papillomavirus, and 5) varicella zoster vaccine if there is no history of shingles or chickenpox and varicella zoster virus serology is negative.[145] Adult patients with IBD who are 60 years or older should receive a respiratory syncytial virus (RSV) vaccine.[142] Live vaccinations should not be given to people with IBD receiving immunosuppressive therapy, inactivated vaccines are safe in patients with IBD.[26][142]

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