People with known IBD should not be advised to take anti-diarrhoeals for a severe flare-up of their disease as this could lead to complications such as toxic megacolon and could cause obstruction in patients with a stricture.
Antispasmodics such as mebeverine, hyoscine butylbromide and alverine citrate are normally recommended for IBS, but IBD patients may also experience IBS so they may be helpful to treat symptoms such as cramps and spasm.
IBD sufferers are generally advised to avoid non-steroidal anti-inflammatory drugs (NSAIDs), where possible, as standard doses have been found to cause a rise in disease activity scores. Low-dose NSAIDs and short-term use is acceptable in patients where IBD is well-controlled, but the risk of flare ups could be higher if given to patients with active IBD.
IBD patients should be advised to have the influenza and pneumococcal vaccines, which are inactivated (non-live), but they may not receive the full benefit if they are already on immunosuppressive treatment.
Patients should be advised not to have any live vaccines, such as certain travel vaccines, while they are on immunosuppressants. Should they require live vaccines, they should be advised to speak to their IBD doctors to determine other options, such as withholding their immunosuppressive treatment. Patients on immunomodulators should be advised to report
any contact with chickenpox or measles to their doctor.