Inflammatory Bowel Disease

About the service

The Inflammatory Bowel Disease (IBD) team provides support to patients with Crohn’s disease or Ulcerative Colitis. The IBD team is a multidisciplinary team of Consultant Gastroenterologists, Surgeons, Registrars, Pharmacists, Nurses and Dieticians, all with specialist knowledge of Inflammatory Bowel Disease.

The service includes

  • Outpatient clinic review (via referral pathway) including; face to face and telephone appointments
  • Inpatient review
  • IBD FlareLine – access via telephone and email
  • Endoscopy investigations
  • Radiology investigations
  • Access to Medical Day Unit
  • Access to Homecare services for biologic therapy
  • Multi-disciplinary team meetings to discuss complex patients and treatment management
  • Colorectal review if required
  • Dietetics review if required
  • Access to Stoma Care
  • Teaching and training to staff, patients and relatives.
  • Patient Panel


 

Meet the team

Lead IBD Clinician: Dr Charmian Banks – Consultant Gastroenterologist

Consultant Team

  • Dr Christopher Alexakis - Consultant Gastroenterologist / Clinical Director
  • Dr Dushen Murugiah - Consultant Gastroenterologist
  • Dr Kalliopi Alexandropoulou - Consultant Gastroenterologist
  • Dr Michelle Gallagher - Consultant Gastroenterologist and Hepatologist
  • Dr Sanju Mathew - Consultant Gastroenterologist and Hepatologist
  • Dr Marinos Pericleous - Consultant Gastroenterologist and Hepatologist
  • Prof Aftab Ala - Consultant Gastroenterologist and Hepatologist

Nursing Team

  • Jenna Robinson – Lead Clinical Nurse Specialist / Advanced Nurse Practitioner trainee
  • Rebecca Yeates – Clinical Nurse Specialist 
  • Elliane Mendoza – IBD CNS
  • Kavitha Karunakaran – IBD CNS

Additional team members

  • Najma Ahmad – IBD Co-ordinator
  • Zarah Ahmed – IBD Specialist Pharmacist

Contact the service

IBD FlareLine Service

If you become unwell between appointments, we provide a flareline service for you to call for help.

The FlareLine is run by IBD Nurse Specialists who can provide expert support and advice about Inflammatory Bowel Disease. Other members of the local IBD team (e.g. doctors or trained administrative staff) may answer them too.

What is the FlareLine for?

They're for IBD patients who:

  • Are having a flare-up or worried about adverse symptoms
  • Are in between appointments
  • Need advice direct from an IBD Nurse Specialist

They shouldn’t be used:

  • In an emergency / as an emergency contact
  • To arrange or change routine appointments
  • For more general information about IBD

Frequently Asked Questions are answered below, and for more general information about Crohn’s Disease, Ulcerative Colitis and other forms of Inflammatory Bowel Disease (IBD), patients can contact the Crohn's & Colitis UK Helpline.

IBD FlareLine Contact details

Telephone: 01483 571122 ext. 2423

Telephone line opening hours: 24hr voicemail

IBD FlareLine email: rsch.ibdnurses@nhs.net

Time to respond: Within 2 working days

 

Frequently Asked Questions

What is a flare up?

This is when symptoms of your Crohn’s disease or Ulcerative Colitis return. These may include;

  • Going to the toilet more than usual for you
  • Loose poo or diarrhoea with any blood or mucus for more than 3 days
  • Abdominal pain
  • Waking up through the night to go to the toilet
  • General feeling of unwell or fever

You may also experience other symptoms such as;

  • Mouth Ulcers
  • Swelling or painful eyes
  • Skin rashes
  • Joint pains or swelling
  • Fatigue

How do I manage a flare up?

Ulcerative Colitis

If you have signs of a flare up and are taking 5-ASA medication, it is safe to double your daily dose for 6 weeks. 5-ASA medications have different brand names, please see below for guidance:

  • Asacol: from 2.4g to 4.8g per day
  • Mezavant: from 2.4g to 4.8g per day
  • Octasa: from 2.4g to 4.8g per day
  • Pentasa: from 2g to 4g per day
  • Salofalk: from 1.5g to 3g per day

Even if your symptoms settle quickly, continue taking the higher dose for 6 weeks then reduce back to the lower dose.

If you have known kidney problems please do not increase your medication without seeking advice first.

If you are prescribed suppositories or enemas and you have a supply of these at home, start these as well as increasing your 5-ASA tablets. It is safe to take them every night to control your symptoms.

If you do not see an improvement to your symptoms please contact the IBD FlareLine.

Crohn’s disease

Please contact the IBD FlareLine via telephone or email, your query will be responded to within 2 working days.

What to do in an emergency?

If the problem is urgent, or the IBD FlareLine is unavailable, patients should contact their GP/ out-of-hours service, ring 111 or go to the NHS England website.

Some signs could include:

  • Stoma blockage: not passing wind or poo or passing watery poo, nausea, bloating or swelling tummy, tummy cramps, swollen stoma, nausea/vomiting or both.
  • Severe dehydration, malnourishment and vomiting.
  • Severe tummy pain, a high temperature and a rapid heartbeat.
  • All medicines have a small risk of side effects, such as chest pain, rapid heartbeat or hives. If you experience any side effects that you are worried about while taking your medicine, contact your IBD team or your GP as soon as possible.

Is Azathioprine a form of immunosuppression medication?

Yes or you may have been started on an alternative immunosuppression medication named 6-Mercaptopurine. You should have been fully counselled about this medication. Please contact your IBD Team if you need further information or click here for the Crohn’s and Colitis UK medication leaflet.

I have been started on Azathioprine/6-Mercaptopurine; do I need a blood test?

Yes. You are required to have a blood test every 2 weeks for the first 4 weeks of treatment, then every 4 weeks until the medical team advise it is safe for you to go on to 3 monthly blood testing.

Can I have the flu and pneumococcal vaccination?

All patients with inflammatory bowel disease should have the annual flu vaccination, and 3-5 yearly pneumococcal vaccination as available.

Can I have a live vaccination whilst taking immunosuppression medication?

No. It is unsafe for you to have live vaccinations whilst taking the following medication;

  • Azathioprine / 6-Mercaptopurine
  • Methotrexate
  • Prednisolone >20mg dosage
  • Infliximab
  • Adalimumab
  • Vedolizumab
  • Tofacitinib
  • Golimumab
  • Ustekinumab

I have been advised I may need ‘biologic’ therapy; do you have any information on this?

Crohn’s and Colitis UK website have some useful leaflets explaining these medications;

You will also be fully counselled by your IBD Team before starting this medication.

Can I take Anti-inflammatory medications such as; Ibuprofen, Diclofenac or Aspirin?

You should avoid taking these medications and discuss with your IBD Team if these are required for another illness. Where possible you could try paracetamol or codeine instead.

Do you have a patient panel?

In the past we had a successful patient panel who helped us secure a second IBD nurse. Due to team constraints we have been unable to meet this year. Should you be interested in joining the patient panel in the future please let a member of your IBD Team know.

Useful Information

Useful websites:

Important Telephone Numbers:

  • Crohn’s and Colitis UK: 0300 22 5700 or helpline@crohnsandcolitis.org.uk
  • Medical Day Unit: 01483 571122 ext. 2424
  • Appointments Centre: 01483 571122 ext. 4002
  • Endoscopy:  01483 571122 ext. 6445
  • Outpatient pharmacy: 01483 571122 ext. 2853
  • Stoma Care Nurses: 01483 571122 ext. 2588
  • Nutrition Nurse Specialists: 01483 571122  ext. 2598
  • Gastro Dietitians: 01483 464119
  • Sciensus Homecare: 0333 103 9499
  • Lloyds Homecare: 0345 2636 123 or enquiries@lpclinicalhomecare.co.uk
  • Alcura Homecare: 0800 980 0686 or patientservices@alcura-health.co.uk