Everyday Illness and Inflammatory Bowel Disease

Compared to coping with the complexities of inflammatory bowel disease, everyday illnesses such as the common cold, 'flu', sore throats, etc., may seem trivial. However, these relatively minor complaints should not be ignored as they may make the overall condition worse.

Colds and 'flu'

Colds and 'flu' tend to strike when you are feeling low and under stress. Poor absorption or lack of dietary intake of certain vitamins may increase vulnerability to these opportunistic infections. If a cold persists for more than a few days without improvement, you should contact your GP - especially if you are taking medication. Some drugs depress the white cells in the blood and these may have become too low. Treatment should include:
  1. Rest - it is important to rest as much as possible to conserve energy and allow the body to fight the infection. This is doubly important if the CD or UC is active as well.
  2. Fluids - the body can easily become dehydrated during bouts of colds and 'flu' and it is important to replace lost fluid. You should aim to consume around 3 litres daily. Again, if the CD or UC is active, it is even more important to keep the fluids up.
  3. Dietary supplements - high doses of vitamin C, (500mg - 1g, 3 times daily), may be helpful. vitamin C stores may be low in CD.

Sore throat

If you develop a sore throat you should contact your GP immediately if you are taking the following medications:
  • Corticosteroids (prednisolone)
  • Azathioprine (Imuran)
  • Mesalazine (Pentasa, Asacol, Salazopyrine)

These drugs affect the immune system and you may need a blood test to check that the white cells have not become too low. If all is well, simple throat remedies such as lozenges or gargles may help relieve the symptoms.

Vomiting

This can be a particular problem in people with inflammatory bowel disease.
  1. It could indicate a possible obstruction due to a stricture, particularly if it is associated with abdominal pain or tenderness.
  2. Medications may not be tolerated - particularly steroids which should not suddenly be stopped.

If vomiting continues for more than 24 hours, you should consult your doctor. Fluids may need to be given via a drip and steroids may need to be given by injection.

Diarrhoea

Despite taking all possible precautions in preventing gastroenteritis, it may occasionally occur. You should attempt to treat this by:
  1. Replacing lost fluids - oral rehydration solutions such as Dioralyte or Electrolade may be helpful.
  2. Rest.

If diarrhoea persists for more than 48 hours you should consult your GP. It is preferable not to take medications such as codeine or Imodium to stop diarrhoea as this may mask a potential cause and possibly cause complications if it is due to a relapse of IBD.Urinary infection Urinary tract infections are characterised by:
  • pain on passing urine (dysuria)
  • frequency
  • loin pain
  • raised temperature
  • general feeling of being unwell

This may be caused by complications of the disease, especially CD where fistulae may develop between the bowel and the bladder, or stones are formed. If you have these symptoms and suspect a urine infection you should consult your GP as soon as possible so that a sample of urine can be obtained and antibiotics commenced without delay.

General aches & pains including toothache, backache and headache

Simple aches and pains can usually be resolved by painkillers and rest. Again, non-steroidal anti-inflammatory drugs such as diclofenac, ibuprofen and indomethacin are not recommended as they can make the IBD worse. If the aches persists despite rest and simple painkillers, you should consult your GP as it is possible that the pain may be a complication of the disease, e.g. sacroileitis. If the pain does not respond to simple analgesia such as soluble paracetamol, or persists for several days, you should consult your doctor or dentist as soon as possible.