TABLE 1.

Two examples of self-management strategies for flares of inflammatory bowel disease

Ulcerative colitis
Mild attack (definition)
Two to five trips to the toilet in 24 h Small amounts of blood Mild urgency Little or no need to get up from sleep Good appetite No fever Normal energy
Mild attack (treatment) Rectal therapies – suppositories > foam > gel > liquid (ease of use) 5-ASA – start or increase oral dose Add rectal therapy 5-ASA suppositories or enemas HC foam, liquid HC or budesonide enemas Combinations (eg, 5-ASA suppositories in the morning and HC foam at bedtime) Consider budesonide (if you choose this, inform your doctor)
Crohn’s disease
Obstructive attack, mild (definition) Feeling ‘off’ Cramps May be a burst of diarrhea, then no bowel movements and no gas Nausea
Obstructive attack, mild (treatment) Nothing to eat or drink for 3 h to 6 h Clear fluids for 36 h, then progress diet gradually Monitor your urine output – aim for straw-colour and good volumes (at least 1 cup each time), every 4 h to 6 h

5-ASA 5-aminosalicylic acid; HC Hydrocortisone