Why is it important?
When an IBD patient is having a flare-up, it’s essential for them to understand what they can do to help themselves. Self-management gives them an active role in their healthcare, empowering them to take more control of their condition and is part of a broader shift in health towards shared responsibility.
Patients should be well informed about the potential signs of a flare-up, such as:
- Loose poo, or diarrhoea which may contain blood
- Urgently needing to poo
- Pain in the tummy area
- Generally feeling unwell
They may also experience symptoms outside the gut during a flare, such as:
- Joint pain and swelling (arthritis)
- Swelling in the eyes
- Mouth ulcers
- Skin rashes
- Fatigue
- Mental health problems
There is also higher risk of malnutrition during a flare-up, meaning there may be increased need for dietetic input for nutrition support and dietary advice.
We know that the prevalence of flare-ups in people with IBD is high. In the 2023 IBD Patient Survey, over half reported experiencing one or more flares in the past 12 months, with 45% reporting three or more flares, and 17% reporting more than five flares in the last year. This highlights the importance of having clear guidance in place for each patient.
Information on what to do in the case of a flare should be incorporated into a patient’s individual treatment plan. They should know who to contact if symptoms worsen, how to self-manage symptoms during a flare, and advice on how best to stay well and prevent future flares, including adherence to treatment.
Examples of good practice include St Mark’s Hospital’s flare-up cards, the ‘Managing my Crohn’s or Colitis flare-up’ leaflet used by Western Hospital, or the ‘Guide managing an IBD Flare’ page available on the University College London Hospitals website. You can also signpost to patient organisations such as Crohn’s & Colitis UK, IA, and CICRA for information and support.