Medication and IBD

Living with a long term illness like IBD can affect you both physically and emotionally. Here we look at factors to do with medication, that may help you to stay well more of the time.

Do I really need to keep taking the tablets? 

When you are first diagnosed you will usually be prescribed medication to help control your symptoms. Once you feel better, you may be tempted to stop taking your medication, thinking you don’t need it. A lot of people get fed up with having to take pills and would rather do without a daily reminder of their condition. Others worry about side effects from their medication.

These are understandable concerns, but many studies have shown that maintenance therapy (continuing to take medication even when you are well) does reduce the chance of a flare up. For example, 5-ASA drugs such as mesalazine are particularly effective for keeping people with Ulcerative Colitis in remission. Immunosuppressants such as azathioprine can also help prevent relapses in both UC and Crohn’s Disease.


Taking your prescribed maintenance therapy on a regular basis can mean that you are less likely to need additional courses of steroids. There is also some evidence that drugs such as mesalazine may reduce the slightly increased risk of bowel cancer for some people with IBD. (For more details see our leaflet Bowel Cancer and IBD.)

For more information about these and other medications see our booklet Drugs used for IBD and our specific drug treatment information sheets.

What if I forget my IBD medication?

The patient information leaflet that comes with your medication should tell you what to do if you miss taking a tablet. If you can’t find this, check with your doctor or IBD nurse. Remembering to take medication can be a problem for some people, especially when they are feeling well. If this happens to you, try to make it part of your daily routine. For example, you could always take your pills at mealtimes or directly after brushing your teeth. Here are some other tips that might help:

• Keep a weekly timetable listing all your medication and when you need to take it.
• Store your pills in a dosette box, organised into compartments.
• Use a mobile phone or computer to remind you when a dose is due. You can also buy Medication Alarms online or from chemists.
• Write a note or perhaps put a reminder card on the back of your front door to remind you to take your medication with you when you are going out.

If you have to take a lot of pills in one day you could talk to your doctor about taking higher dose pills less often. There are now one-a-day versions of mesalazine, for example, which have been found to be just as effective as twice-daily lower dose tablets.

What about side effects?

Most drugs can have side-effects and this includes those used to treat IBD. Not everyone will get the side effects and they may be only temporary, but some can be upsetting. They may also mean a different drug would suit you better. So, if you are worried about side-effects or have any other concerns about your medication do talk to your GP, specialist doctor or IBD nurse. They need to know if your treatment is causing problems and there may be an alternative you can take.


Vaccinations and other medicines

If you are taking certain drugs such as steroids and immunosuppressants, you could be more vulnerable to catching infections. This is because these drugs lower your immune system. Try to avoid people with coughs, colds and flu. Health professionals strongly recommend having an annual flu vaccine if you are on immunosuppressants.

To help avoid gastrointestinal infections be careful with hygiene when preparing and cooking food. You may also need to take extra care if you travel abroad and visit countries with a greater risk of food and water-borne infections. See our leaflet, Travel and IBD, for more information and suggestions about travelling safely with UC or Crohn’s Disease. 

If you need to take over-the-counter medicines, it is probably better to avoid ibuprofen and diclofenac. These are drugs known as NSAIDs or non-steroidal anti-inflammatory drugs, and research suggests they may trigger a flare-up.

Some people may also be affected by aspirin, so for simple pain relief paracetamol may be a safer option. If you find you keep needing help with pain, talk to your GP.