IBD treatment: a practical guide
Short patient information to print or keep.
How we check whether treatment is working
Some treatment settles a flare; regular maintenance treatment helps prevent another one. Feeling better does not always mean the inflammation has healed. I use your symptoms, blood tests, calprotectin and, when needed, endoscopy or scans to check your response.
Treatment depends on the type of IBD
Mesalazine is mainly a UC treatment, given orally, rectally or both. Suppositories and enemas reach different areas. It is not a reliable general Crohn's treatment. Other immune-targeting medicines are selected for your circumstances.
Use steroids safely
Steroids are short-term flare treatment, not maintenance. Follow the prescribed course and any reduction plan. Do not stop suddenly, double doses or restart leftover tablets without advice. Repeated courses require review of the longer-term treatment.
Keep your blood tests and vaccinations up to date
Certain treatments need infection screening, vaccination review and ongoing blood tests. Ask before live vaccines or travel. Tell other prescribers about all medicines. Report fever, possible infection or side effects and ask about a scheduled dose. Agree who reviews results and whom to call between appointments.
Tell me if treatment is difficult to manage
Continue maintenance treatment as prescribed. Discuss missed doses, cost, injection difficulties and pregnancy or breastfeeding plans before stopping. Many treatments can continue, but others need change. Nutrition supports recovery and is not a universal cure.
Recognise urgent symptoms
Increasing blood or diarrhoea needs advice. Severe pain, swelling, repeated vomiting, dehydration, heavy bleeding or frequent bloody diarrhoea with fever needs urgent assessment. Do not self-treat a severe flare with loperamide. Call 111 for collapse or unsafe travel.
Worsening symptoms or infection need advice
Contact the team looking after your IBD or your GP promptly for increasing blood, diarrhoea, fever or suspected medicine side effects. If you are significantly unwell or have an infection around a scheduled dose, seek advice about that dose rather than making a blanket decision to stop all medicines.
Severe pain, a swollen abdomen, repeated vomiting, heavy bleeding, dehydration or frequent bloody diarrhoea with fever need urgent assessment. A severe flare should not be self-treated with loperamide.
Call 111 for collapse, severe breathing difficulty, a severe allergic reaction, or if you are too unwell to travel safely. Do not wait for an email reply.
General information. Follow your own care instructions.