What is the likely complication in a patient who is noncompliant with mesalamine therapy for ulcerative colitis?

In patients with ulcerative colitis, mesalamine is a commonly prescribed medication for long-term management and maintenance of remission. It works by reducing inflammation in the intestinal lining and preventing flare-ups of the disease. When patients are noncompliant with their mesalamine therapy, they are at increased risk of experiencing an exacerbation of their symptoms, commonly referred to as a flare-up of colitis.

This flare-up can manifest with symptoms such as increased diarrhea, abdominal pain, rectal bleeding, and overall deterioration of the patient's condition. Continued noncompliance may lead to worsening inflammation, further complications, and even hospitalization if the colitis becomes severe.

While complications like colon cancer can arise in patients with long-standing ulcerative colitis, these typically develop over many years and are not a direct or immediate consequence of noncompliance with mesalamine therapy. Severe dehydration could occur during a severe flare, but it is not the primary concern when considering the immediate consequences of stopping medication. A perforated colon is a severe and rare complication that can occur but is not directly linked to medication noncompliance in the context of ulcerative colitis management. The most immediate and likely consequence of noncompliance in this scenario is the acute flare-up of col