The Dual Control Approach:
Your Disease, Your Life, No Compromises
Your Disease, Your Life, No Compromises
IBD is most commonly diagnosed between the ages of 15 and 40, the years when you're chasing a career, building relationships, planning a family, figuring out who you are, and dreaming of a better tomorrow. 12
IBD shouldn’t get to decide what dreams get put on hold.
Dual Control means pursuing healing backed by evidence, so your ambitions don't stay on pause. 3
What Is the Dual Control Approach to IBD?
Dual Control has two inseparable priorities: pursuing long-term healing inside the gut, and protecting your freedom to live on your own terms.
For people living with ulcerative colitis (UC) or Crohn's disease (CD), this means looking past whether symptoms have quietened down and asking whether inflammation is actually resolving.
Inflammatory Bowel Disease (IBD) can be deceptive. A significant proportion of patients whose symptoms improve still have active inflammation visible during endoscopy. This "silent inflammation" can drive flare-ups, disease progression, and the unpredictability that makes it impossible to commit to anything with confidence. 3
The milestone that addresses this is endoscopic remission — when a gastroenterologist confirms, through colonoscopy or sigmoidoscopy, that there are no visible ulcers or active inflammation in the gut lining. It's a higher bar than clinical remission, and it's one worth aiming for. 3
of IBD patients define remission simply as the absence of symptoms and feeling better. 4
of Doctors set endoscopic remission as the gold standard of care. 4
The gap between no symptoms and endoscopic remission isn’t a technicality - it’s the difference between feeling better and knowing your condition isn’t holding you back
Why Feeling Better Isn’t the Full Picture
When your symptoms ease, the urgency fades, the pain settles, and you can get through a day without planning around your gut. It feels like your treatment is working, and in that moment - it is.
But what's happening on the inside can be different from what you experience on the surface. Research has shown that a significant proportion of patients whose symptoms have improved still have active inflammation visible during endoscopy.
This is sometimes called "silent inflammation", and over time, it can contribute to disease progression, flare-ups, and complications. 3
What Endoscopic Remission Means for Your Future
New data presented at Digestive Disease Week (DDW) 2026 reinforces the connection between endoscopic remission and meaningful long-term outcomes for people living with both ulcerative colitis (UC) or Crohn's disease (CD). 35
Two retrospective analyses using the Crohn's & Colitis Foundation database examined what happens when patients achieve endoscopic remission and found:
Patients achieving endoscopic remission had a 68% lower risk of symptom worsening and were 4 times less likely to require IBD-related surgery. 3
Patients who achieved endoscopic remission showed a 41% lower risk of symptom worsening, were 3 times less likely to require IBD-related surgery and had reduced steroid use. 5
What this means for you:
Stability
Longer stretches of stability with fewer flare-ups derailing your plans.
Less Steroids
Healing of the tissues means less long-term dependence on steroids.
Low surgical risk
A lower likelihood of needing surgery in the future.
Confidence
Say yes to the job, the trip, your dreams, knowing your body is more likely to keep up.
These findings don't guarantee a specific outcome for every patient, and treatment goals should always be set with your gastroenterologist based on your individual circumstances.
But the direction of the evidence is clear: pursuing long-term remission opens up more of your life.
Questions to change your treatment conversations
Want to talk to your doctor about long-term remission, but don’t know where to start? Get practical advice and tips from our patient conversation guide.
Not All Treatments Work the Same Way
Different biologics target different pathways in the immune system. Some act on a single pathway. Others are designed to act on two pathways at once, addressing inflammation through a dual mechanism.
The way a biologic works shapes the results you're likely to see and the life you're able to lead while on it.
You deserve to know not just that your treatment is a biologic, but how it works, why it was chosen, and whether there are options that might work differently, or help you achieve your dreams.
What matters for your IBD treatment?
Not all IBD treatments work in the same way. Stay up to date on the latest breakthroughs in IBD therapies and understand how the mechanisms of action differ among existing treatment options.
Modern biologics can be self-injected at home or given as infusions at a clinic. Treatment that works around your schedule, not the other way around, is treatment you can easily build into your life.
A treatment schedule you can maintain consistently has the best chance of delivering lasting results, making long-term remission a possibility.
Learn more about the stages of long-term remission
You Are Not Alone: Bridging the Gap Across Asia Pacific With Shared Decision-Making
If you’ve never heard of endoscopic remission, you are not alone.
Less than 40% of IBD patients had previously heard the term "mucosal healing" at all. But among those familiar with it, two-thirds recognised it as an important indicator of remission. The appetite to understand is there, but how to access information is not. 46
53% of patients worry about asking too many questions during their medical consultations. 7
30% of patients express dissatisfaction with the depth of dialogue at appointments 8
Evidence on how shared decision-making is implemented in routine practice remains limited. 9
These are systemic challenges, not individual failures.
That’s why we launched The Dual Control campaign in September 2025, to address these systematic failings. Through locally tailored initiatives such as the Gut Tunnel Experience in Singapore, an Asia-Pacific patient conversation guide, and education programmes, including IBUDDY in Japan and integrated initiatives in China and South Korea, we want to help patients like you gain the freedom you deserve to pursue your dreams.
Partner with your physician to pursue long-term remission today
Read our patient conversation guide, designed to help you ask your doctor the right questions with confidence.
