YouTube videos support multilingual subtitles. Please turn on subtitles to watch.
Ulcerative Colitis Treatment Case:
The Endless Cycle of Relapse
Beyond symptom relief, toward complete normalization of inflammatory markers
A Patient's Story in Their 40s
Hello. This is HanStep Korean Medicine Clinic, which has been researching and treating ulcerative colitis since 2007. The patient began experiencing mucus in their stool around July 2023 and was diagnosed with ulcerative colitis via colonoscopy. After initial Western medical treatment showed no improvement, they alternated between pharmacy-bought herbal medicine and other Korean medicine clinic treatments, experiencing repeated cycles of improvement and worsening.
Although they experienced 'clinical remission'—where symptoms disappeared—twice, they relapsed again in March 2025. This time, even the previously effective medications did not work, leading them to visit our clinic.
Main Symptoms at Time of Visit (May '25)
- Western Medication: Discontinued
- Bowel Movement Status: 2–4 bowel movements per day, bloody stool twice a week, always accompanied by mucus
- Digestive Status: Chronic indigestion and reduced food intake
- Notes: Bloating and cessation of bowel movements when consuming cold food; accompanied by rhinitis
Does the disappearance of symptoms mean a full recovery?
The patient’s symptoms improved twice but kept relapsing. Even if you reach 'clinical remission' (a state without symptoms), if inflammation remains microscopically in the intestine, it can worsen again at any time. Just as having a bit of gastritis doesn't always cause heartburn, patients may not feel symptoms if colonic inflammation levels are below a certain threshold.
True completion of treatment lies not in the 'disappearance of symptoms' but in the 'complete normalization of inflammatory markers.'
What markers should we look at?
Differences between general inflammatory markers in blood tests and stool tests
WBC, CRP, ESR
General inflammation markers such as white blood cell (WBC) count or CRP levels usually appear normal in ulcerative colitis patients. This is because ulcerative colitis is an autoimmune disease, and the inflammation on the surface of the intestinal mucosa does not affect the blood.
Stool Calprotectin
This is a substance released by inflammatory cells that have migrated into the intestine. Since it is excreted through stool, measuring this level provides the most accurate indication of the degree of intestinal inflammation. It is a highly reliable marker that shows over 80% correlation with endoscopic findings.
Treatment Progress and Changes in Markers
First Visit and Start of Treatment
Bloody stools and mucus continued, and digestive capacity was significantly impaired. Treatment was initiated with a complex prescription targeting both digestion and inflammation.
Significant Improvement in Clinical Symptoms
After one month of treatment, bowel movements stabilized to once per day. Bloody stool disappeared, and mucus in the stool decreased significantly. Digestive discomfort such as feeling heavy or stinging after overeating was also resolved.
Complete Normalization of Markers
Through rhinitis treatment and a switch to an inflammation-focused prescription, the calprotectin level fully normalized to less than 3.8. Bloody and mucous stools have disappeared, and normal stool patterns are being maintained.
Closing
In the treatment of ulcerative colitis, the improvement of symptoms is very important. However, it is essential not to stop there, but to continue monitoring stool inflammatory markers to ensure the inside is perfectly healed. HanStep Korean Medicine Clinic will assist you.