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Self management plan for IBD

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Severe symptoms include:

  • 6+ trips to the toilet.
  • Nocturnal symptoms.
  • Large volumes of blood.
  • Fever.
  • Pain.
  • Weight loss.

Optimise other treatment as for mild to moderate flares but you will likely  need steroid course.

Contact IBD helpline now.

Mild to Moderate symptoms include:

  • 2 to 5 trips to the toilet in 24hrs (or noticeable increase from your usual frequency).
  • Small amounts of blood.
  • Mild urgency.
  • Little or no need to get up from sleep.
  • Good appetite and energy.
  • No fever.

Treatment of Mild to Moderate flares

Use mesalazine suppositories 1g at night, or increase to 1g twice a day.

Start / increase oral mesalazine to max. treatment dose (e.g. 4g per day of Pentasa, 4.8g per day of Asacol, 3g per day Salofalk granules).

Access more supplies from your GP.

Review progress at one week

If you are getting better:

  • Continue this increased treatment until you are feeling well (4-6 weeks).
  • Then gradually reduce (over a few weeks) to your usual baseline.
  • If you are using suppositories as maintenance, then three times a week should be enough.
  • Oral medication should remain daily

If you are NOT getting better:

Top Tips For Keeping Well With Your Colitis

Avoid non-steroidal anti-inflammatories (such as ibuprofen, diclofenac, naproxen).

Knowledge is power!

  • Learn about your colitis at
  • Join your local CCUK group.
  • Attend a study day or new patient group.
  • Know your flare triggers.
  • Stress and tiredness can’t always be avoided, but make sure you look after yourself.
  • Find time to rest, relax and exercise.
  • Seek help if stress is getting on top of you.
  • Be extra vigilant for early symptoms during these times.


  • Eat a healthy balanced diet.
  • Do not starve yourself to artificially reduce your need to go to the toilet.
  • During a flare up:
    • Eat small amounts regularly.
    • Drink plenty of fluids.
    • Reduce your fibre intake.

Get a CCUK “Can’t Wait!” card and a RADAR key, to allow you access to disabled toilets.

Don’t stop or alter your medication without discussing it with your IBD team.

Keep in touch:

Let us know straight away if you are having trouble:

Telephone: 01273 664427.

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

Publication Date: April 2022

Review Date: September 2023

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