There are some things that you can do to help manage your flare.  There is an advice line for all patients on 01276 526953.  Messages can be left on this answerphone. Another way of contacting us is via email on frimleyibd@fhft.nhs.uk.  Please bear in mind that whilst we do try to answer enquiries in a timely manner, the nature of condition means that sometimes we have address the enquiries of the patients with the most pressing needs.

The treatment of your IBD is usually shared between your GP and ourselves.  Whilst we see many patients with IBD, your own GP may only have a few patients with the condition.  Some GPs will defer a lot of the decision making about your care to the hospital IBD team, whilst others are happy to manage problems at their own surgery.

If you are unhappy with your IBD care that you are receiving you are entitled to a second opinion.  The IBD nurses or GP can help you with this if you do not want to ask your doctor.

Take your medications as prescribed and do not stop them even if you are feeling better.  Ensure that you have adequate supply of your medication and get your repeat prescriptions in good time.  If you are suffering from a flare, prompt action can often prevent a flare from getting worse.  If your symptoms are flaring over 48 hours then please contact your GP or the IBD nurse helpline for further advice.

Many patients report that their symptoms of IBD worsen in stressful periods.  Being mindful to stressful situations and adopting stress management techniques can be helpful.

Try to avoid situations that could lead to a gastrointestinal infection.  So store, prepare and cook your food appropriately.  Pay attention to your hand hygiene.  Take appropriate precautions during foreign travel. See the Crohn’s and Colitis UK website. 

Where possible you should avoid taking these types of anti-inflammatories as they can trigger a flare.  You could try Paracetamol or codeine instead.  But bear in mind that codeine can lead to constipation and should be taken cautiously. 

It should be clear, when you have been prescribed the medications if the treatment is to continue or not.  If you are unsure then please ask your GP or contact the IBD nurses.  The information may be on your clinic letter.  For most medications the initial prescription will be given in clinic but repeat prescriptions should be obtained from your GP.  For certain medications such as Azathioprine, 6 Mercaptopurine or Methotrexate the dose that you need to take can alter in the first few months.  Whilst the hospital team are adjusting your medications, your repeat prescriptions will need to be provided by the hospital.  Once your doses have been established your GP usually takes over the repeat prescriptions, but there are certain ones that will always need to be dispensed via the Hospital pharmacy.

If you do un-expectedly run out of your medication then please contact either your GP or the IBD nurses, and we will try to help as best we can. Please give at least a week’s notice if a prescription is required.

Rectal treatment, suppositories or enemas, are often used to treat inflammatory bowel disease particularly if your disease just affects the left side of the bowel.  The rectal treatments can be used alone or in combination with oral medication to treat your condition.  They can be very effective in getting a high concentration of the drug exactly where it needs to be and can lead to faster resolution of your symptoms.  Using them just before bedtime, after a hot shower for example, may make them easier to use.  KY lubricating gel or some water can be applied to the applicator or suppository before insertion.  If your bottom is sore your GP can prescribe some gel that has a local anaesthetic in it, such as instillagel.

You need to have blood tests taken every 6 months when you are on these medications.  The blood tests are to ensure that the medications are not affecting your kidneys, liver and bone marrow.

There is a useful information leaflet about these  medications on the Crohn’s and Colitis UK website

Azathioprine mercaptopurine.pdf

Methotrexate is often given to patients with IBD as an alternative to Azathioprine or 6 Mercaptopurine. There is an information leaflet on the Crohn’s and Colitis UK website.

Methotrexate-YP-guide.pdf

Methotrexate.pdf

When you are started on these medications or any dose adjustments you need to have regular blood tests.   These are to ensure that the medicines that you take are not affecting your kidneys, liver and bone marrow.  The schedule for blood tests are outlined below:

When you have had your blood taken please contact the IBD nurses on frimleyibd@fhft.nhs.uk so that they can check your results.  If there are any abnormalities your will be contacted.

You may be wondering if diet has caused your illness or can be used to treat your symptoms.  There is useful information leaflet on the Crohn’s and Colitis website.  This includes information on a low fibre diet, low FODMAP diet and general advice for healthy eating.

The Crohns and colitis website has some useful leaflets explaining these medications.

Infliximab

Adalimumab

Vedoluzimab

Most patients with Ulcerative Colitis or Crohn’s disease can expect to have a normal pregnancy and a healthy baby.  It is important for your discuss your pregnancy with the hospital team.  There are useful information sheets on the Crohn’s and Colitis UK website:

Pregnancy and IBD

Fertilty and IBD