All information is correct at time of printing and is subject to change without notice. The Devon Formulary and Referral Website is not in any way liable for the accuracy of any information printed and stored by users. For the most up-to-date information, please refer to the website.
This section provides guidance on the treatment of patients with ulcerative colitis and Crohn's disease. The aim of treatment is the induction and maintenance of sustained clinical and endoscopic steroid-free remission using the least toxic therapy. Treatment strategy is influenced by disease activity (mild/moderate/severe), distribution, pattern (e.g. relapse pattern or extraintestinal manifestations) and response and side effects of previous medication.
Inflammatory bowel disease (IBD) is diagnosed and managed in secondary care. However, a number of medications used are suitable for continuation in primary care, some under formal shared care arrangements, others simply as repeat prescriptions of standard maintenance therapy. Aminosalicylates and corticosteroids form the mainstay of routine therapy.
A toolkit has been developed in partnership between the Royal College of General Practitioners (RCGP) Clinical Innovation and Research Centre and Crohn's and Colitis UK, to aid GPs and other primary care professionals when managing patients with IBD. This can be accessed here.
Recognition of severe colitis
Consider admission directly to Gastroenterology for patients with 6 or more bloody motions/day + 1 or more of the following:
Mild-moderate disease: proctitis
Mild-moderate disease: left sided or extensive
Severe disease
When treating an acute flare with rectal mesalazine, local specialists note:
Ileocaecal
Colonic
Upper GI