I Kept Forgetting to Take My IBD Meds — Here’s What Happened

I was dealing with several other health conditions, and my IBD was in remission, so I lost my focus — and paid the price.

People with chronic illnesses often depend on medication — whether for survival or for symptom management and quality of life. The latter is certainly the case for people with inflammatory bowel disease (IBD).

Yet remembering to take medication isn’t always easy, especially with the busy lives we lead today. If you take several daily medications, then remembering to take IBD medication can be that much harder.

I was keenly reminded of the importance of making this a daily routine recently when I forgot to take the medication for my ulcerative colitis (UC), a form of IBD, for a month.

Here’s what happened, and why it’s so important that you remember to take yours!

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Forgetting my meds

I live with several different chronic illnesses and conditions — 12, in fact. For these, I currently take 10 different daily medications. And they all have to be taken at specific times and spaced out at certain intervals.

Around the beginning of April 2024, I started a new medication for my chronic idiopathic urticaria (aka hives with an unknown cause). It was at this point that I began to forget to take my IBD medication.

Now you may wonder how this was even possible. One reason was that I needed to take my new medication at the time I would normally take my IBD medication. I was so fixated on trying to take the new tablet that I forgot about my IBD meds.

And secondly, it was possible because my IBD was in remission while my urticaria was not.

I’m not alone in this; studies have confirmed that feeling well can cause people with IBD and other chronic illnesses to skip their meds.

After all, it can be easy to forget about an illness — or even believe you don’t need the medication — if it isn’t affecting your life at the moment. Since I live with so many different health conditions, I tend to focus on those that are active and forget about those that are under control.

But that was certainly a mistake.

IBD is a serious health condition. Being in remission does not equate to being nonexistent. However, at that time, with several other health issues flaring and a new medication starting, it was easy for me to forget that.

So, what happened?

I was supposed to take 1 gram of 5-ASA (also known as mesalamine) for my UC three times a day.

It wasn’t as if I stopped this medication completely.

At first, I would only remember to take it twice a day, then once, and then days went by when I would forget to take it altogether. This went on for about a month.

Then one day in May, my symptoms returned with a vengeance. Intense abdominal pain and cramping. Lots of diarrhea. Strong nausea. Feeling faint on the toilet.

It reminded me of days long ago when my IBD was at its worst. And it struck me as I was having those symptoms: When was the last time I’d taken mesalamine? When was the last time I’d taken it at its full dose?

I couldn’t recall.

What did I do next?

I immediately took my full dose that day. But the fact remained that I was now a month behind on adhering to a full mesalamine dosage and that I was struggling to remember to take all my medications. So I did two things.

First, I added a reminder on my phone calendar that repeated every evening: IBD MEDICATION?

Second, I learned that it’s often recommended to take the full dose (3 grams) all at once, so I began doing that at the end of the day when that notification appeared, rather than splitting it up into three doses.

This was a far more convenient way for me to take it, and with the reminder on my phone, it soon became planted into my mind that I needed to take my medication.

It took a couple of weeks for the flare-up to fully settle, and during that time, I ensured that I avoided any of my dietary triggers and stuck to nonfibrous food.

But overall, I consider myself very lucky. While I was experiencing this, I began to investigate medication adherence with IBD, which opened my eyes to its importance, and to the dangers of forgetting to take your meds.

The research

It may sound obvious that if you don’t take any of your medication, you’ll become sicker.

But “medication adherence” (or nonadherence) encompasses a range of behaviors, not just perfect compliance or absolute refusal to take a recommended treatment. It can reflect how frequently a person takes the correct dose, how often they skip doses, and how consistently they take their medication.

In developed countries, only about 50% of people with chronic diseases take their medications as prescribed.

People with IBD are no exception. A recent study of 164 people with IBD revealed that about a third of them had less than a medium degree of adherence to their medication plan.

The factors that most commonly prevented them from taking meds as prescribed were:

• traveling and other changes in routine
• being busy or in a hurry

People who didn’t renew a prescription said it was usually due to:

• not noticing when it had run out
• side effects
• cost

Another study of 105 people with IBD found that they were less likely to adhere to their medication if:

• they had to take frequent doses
• they took their medication in oral form rather than as an injection

“This may be related to the fact that oral medication is mostly mesalazine, which is taken frequently, easily forgotten, and delayed by work and life chores, while injectable medication is mostly biologic, mostly administered once every 8 weeks, with less frequency and fewer adverse effects, so patients are relatively more likely to comply,” the authors suggested.

It was also noted that the more educated people were about their disease, the more likely they were to take their medication as prescribed.

It’s important to understand that not adhering to medication can have serious consequences, like increased disease activity and relapse, poor response in the future to IBD medications, and worse quality of life.

Life hacks to help you remember your meds

Since people who have to take their medication more frequently are more likely to forget or skip a dose, it might help to try one of the following strategies:

• Place each dose in a different container, and make sure the correct container is with you wherever you’ll be at the time you need it.
• Use phone reminders or alarms.
• If you prefer going old school, use paper and pencil to cross off each dose on a calendar after you take it.
• Tie your medication to another habit in your routine, like eating a meal or brushing your teeth.
• Use pill boxes.
• Consider talking with your doctor about a simplified dosing schedule or change in medication type.

The takeaway

Adhering to IBD medication is an important part of maintaining disease control. It can be easy to forget to take medications, but finding strategies to get back on track is essential so that you can avoid flares and relapses like I had, or other serious health risks.

Use any strategy necessary to help remind you that your medication is important and that you need to take it consistently, as prescribed, to keep your IBD at bay.