Which medicines can be used?
- Corticosteroids to reduce inflammation. Enemas and suppositories are used for mild to moderate symptoms in the rectum. Tablets are used for moderate to severe symptoms and more extensive disease. Hospital admission and injections of corticosteorids are required for very severe symptoms and extensive disease.
- Aminosalicylates, as tablets, enemas or suppositories. These are anti-inflammatory medicines for the treatment of mild to moderate symptoms. They can also be used continuously to prevent attacks. Commonly used aminosalicylates in the UK are mesalazine and sulphasalazine.
- Immunosuppressants, such as azathioprine (eg Imuran), are used for very severe symptoms that cannot be controlled by corticosteroids (unlicensed indication). Infliximab is a relatively new treatment when it is not possible to use steroids or they have been ineffective.
- Neoral (ciclosporin) can be used for very severe attacks but has some serious side-effects so is only used occasionally.
- Stool bulking agents are used when the bowel works only slowly.