From the Guidelines
If you're experiencing an IBD flare-up, contact your gastroenterologist immediately for personalized guidance, as prompt treatment helps prevent complications and restore remission more quickly 1.
IBD Flare-Up Management
In the meantime, take your prescribed medications as directed, which may include anti-inflammatory drugs like mesalamine (typically 2.4-4.8g daily), corticosteroids like prednisone (often starting at 40mg daily with tapering), or immunomodulators like azathioprine (1.5-2.5mg/kg daily) 1. Some key points to consider during an IBD flare-up include:
- Staying hydrated and following a low-residue diet by avoiding high-fiber foods, raw fruits and vegetables, nuts, seeds, and spicy or fatty foods 1
- Eating small, frequent meals of well-cooked, soft foods like white rice, pasta, lean proteins, and cooked vegetables
- Resting adequately and managing stress through relaxation techniques
- Keeping track of your symptoms including frequency of bowel movements, presence of blood, pain levels, and fever to report to your doctor
Importance of Prompt Treatment
Flares occur when the immune system becomes overactive against the intestinal lining, causing inflammation and symptoms like diarrhea, abdominal pain, and bleeding 1. The goal of treatment is to induce remission, and then maintain it to prevent future flare-ups, which can be achieved through a combination of medication, lifestyle changes, and regular monitoring by a healthcare provider 1. It's essential to work closely with your gastroenterologist to develop a personalized treatment plan that takes into account your specific needs and medical history 1.
From the Research
IBD Flare-Up Management
- The management of inflammatory bowel disease (IBD) has undergone significant changes over the past century, with advancements in drug therapy contributing to a decrease in the severity of the condition 2.
- The pharmacological management of IBD has been expanded to include 5 main drug classes: 5-aminosalicylates, corticosteroids, immunomodulators, biologics, and antibiotics 2.
- Patients with IBD use various coping strategies to manage flare-ups, including lifestyle modifications such as changing meal contents and getting more sleep 3.
- The use of medications, such as topical corticosteroids and elemental diet, is also considered effective in managing flare-ups 3.
Treatment Options
- Mesalamine is a commonly used medication for the treatment of IBD, and recent studies have reappraised its effectiveness in reducing the risk of colorectal neoplasia 4, 5.
- Mesalamine has been shown to be effective in reducing the risk of colorectal neoplasia, particularly at doses greater than 1.2 g per day 5.
- Sulfasalazine, on the other hand, does not seem to reduce the risk of colorectal neoplasia 5.
Emergency Department Management
- Patients with IBD flares often present to the emergency department with nonspecific signs and symptoms, and it is essential to differentiate a mild flare from a life-threatening intra-abdominal process 6.
- Laboratory testing, imaging, and identification of surgical emergencies are critical in the management of IBD flares in the emergency department 6.
- Coordination of care with specialists and provision of resources for ongoing support are also important in the management of IBD flares 6.