EMR IBD Education Tool

The Electronic Medical Record (EMR) webpage is an innovative resource for providers to quickly access and integrate relevant inflammatory bowel diseases (IBD) education materials into individual EMR systems to provide to patients.

To begin, search for the topic you're interested in. Then, follow the instructions to integrate information into your EMR system.

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6-mercaptopurine (6-MP)

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6-mercaptopurine (6-MP)

Dear @Name@,

Your doctor has discussed the following subject with you: 6-mercaptopurine. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • Infrequently reported side effects may include headache, nausea, vomiting, diarrhea, tiredness, mouth sores, rash, fever, joint pain, and liver inflammation. Less common side effects include inflammation of the pancreas (pancreatitis), infections, and lymphoma (cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Aminosalicylates

Dear @Name@,

Your doctor has discussed the following subject with you: aminosalicylates. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Anemia

Dear @Name@,

Your doctor has discussed the following subject with you: anemia. Here is some additional information. Let us know if you have any questions regarding this information.

People with Crohn's disease or ulcerative colitis are at risk for anemia. If you have anemia, you have less blood to carry oxygen to the rest of your body. Approximately one in three people with Crohn's disease or ulcerative colitis have anemia. The most common symptom is feeling tired. Other symptoms can include dizziness, headaches, cold hands or feet, pale skin, and shortness of breath.

The most common cause is low iron. Inflammation in your intestines can interfere with your body's ability to use iron or absorb iron. Other causes include blood loss from intestinal bleeding, poor absorption of vitamins and minerals (like vitamin B12 and folic acid), or medications.

Not everyone experiences symptoms, so it is important that you get tested with a simple blood test. Iron deficiency can be serious, but treatment is available. Individuals with inactive Crohn's disease or ulcerative colitis can take oral iron supplements. If you have active Crohn's disease or ulcerative colitis, or you cannot tolerate oral iron, then you may need intravenous iron. Other important factors in treatment include vitamin B12 or folic acid supplements, getting Crohn's disease or ulcerative colitis under control with the right medication, and blood transfusions in severe cases.

Please be sure to follow up with your provider with any questions.

Your provider can also discuss the Crohn's & Colitis Foundation's IBD Anemia Care Pathway with you at your visit. The pathway uses guideline recommendations to identify and manage anemia.

This resource is supported by Luitpold Pharmaceuticals

Antibiotics

Dear @Name@,

Your doctor has discussed the following subject with you: antibiotics.  Here is some additional information. Let us know if you have any questions regarding this information.

  • Antibiotics are mostly used to treat infections inside the body, but can be used to reduce irritation and inflammation in the intestines.  It can also be used to treat disease complications (like abscesses or fistulas) and can be given after surgery.
  • It is usually given as a pill, but can sometimes be given as an intravenous injection.
  • Antibiotics are generally well tolerated by the body, but may cause side effects such as nausea, vomiting, loss of appetite, rash, diarrhea, dizziness, and headaches.
  • Before taking these medications, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed.  Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again.  Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately. 

Anucort (hydrocortisone)

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Anucort (hydrocortisone)

Dear @Name@,

Your doctor has discussed the following subject with you: Anucort. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given as a suppository to reduce inflammation in the anus, rectum or the last part of large intestine.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Long-term use can result in a weakening of the muscles in the anus and rectum.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Apriso (mesalamine)

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Apriso (mesalamine)

Dear @Name@,

Your doctor has discussed the following subject with you: Apriso. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • It is important to take the pill with plenty of water.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Arthritis

Dear @Name@,

Your doctor has discussed the following subject with you: arthritis. Here is some additional information. Let us know if you have any questions regarding this information.

Arthritis, or inflammation (pain with swelling) of the joints, is the most common complication of inflammatory bowel disease (IBD) that appears outside of the gastrointestinal tract. Although arthritis is typically associated with older age, in IBD, it often strikes younger patients as well. There are two types of arthritis commonly seen in IBD.

Peripheral arthritis usually affects the large joints of the arms and legs. If left untreated, the pain may last from a few days to several weeks. The level of joint inflammation generally mirrors the extent of inflammation in the intestine. Although no specific test can make an absolute diagnosis, various tests—including analysis of joint fluid, blood tests, and X-rays—may be used to rule out other causes of joint pain. In the general population, people with peripheral arthritis may use nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, to reduce pain and swelling of the joints. However, these medications are not a good option for everyone with IBD because they can irritate the intestines and increase the inflammation. It is important to discuss the use of NSAIDs with your doctor. In addition to medication, doctors may recommend resting the affected joint, use of moist heat, or range of motion exercises, as demonstrated by a physical therapist.

Axial Arthritis is also known as spondylitis or spondyloarthropathy. Axial arthritis produces pain and stiffness in the lower spine and at the bottom of the back (sacroiliac joints). These symptoms may come on months or even years before the symptoms of IBD appear. This form of arthritis may cause permanent damage if the bones of the vertebral column fuse together—thereby creating decreased range of motion in the back. Therapy often includes the use of biologic therapies. Non-medical therapies are geared toward improving range-of-motion in the back. Stretching exercises are recommended, as is the application of moist heat to the back.

Asacol HD (mesalamine)

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Asacol HD (mesalamine)

Dear @Name@,

Your doctor has discussed the following subject with you: Asacol HD. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • It is important to take the pill with plenty of water.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Azasan (azathioprine)

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Azasan (azathioprine)

Dear @Name@,

Your doctor has discussed the following subject with you: Azasan. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • With this medication it can take 3 to 6 months to see an improvement of symptoms. Because it may take a while to see an improvement, they are often given along with another faster-acting medication (such as a steroid).
  • Infrequently reported side effects may include headache, nausea, vomiting, diarrhea, tiredness, mouth sores, rash, fever, joint pain, and liver inflammation. Less common side effects include inflammation of the pancreas (pancreatitis), infections, and lymphoma (cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Balsalazide (Colazal)

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Balsalazide (Colazal)

Dear @Name@,

Your doctor has discussed the following subject with you: Balsalazide. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Biologics

Dear @Name@,

Your doctor has discussed the following subject with you: biologics. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again.Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Bone Loss

Dear @Name@,

Your doctor has discussed the following subject with you: bone loss. Here is some additional information. Let us know if you have any questions regarding this information.

Bone loss is a common problem, affecting 30 to 60% of people with Crohn's disease and ulcerative colitis. Bone loss can affect people with inflammatory bowel disease (IBD) at any age and typically occurs without symptoms, until the bone becomes so soft that it breaks or fractures. Steroid medications increase your risk for bone loss. Active IBD inflammation, low levels of vitamin D, and smoking also increase your risk for bone loss.

Screening for bone loss is done with a study called a Dual Energy X-ray Absorptiometry or DEXA scan. If thinning of the bones is found, then your doctor will start therapy to prevent further bone loss. Your DEXA scan report may include terms such as osteopenia (mild weakening of the bones) or osteoporosis (significantly weakened and fragile bones). To prevent bone loss, you should minimize use of steroids (as recommended by your doctor), stop smoking, exercise regularly, eat a diet rich in calcium and vitamin D, or speak with your doctor about taking calcium and/or vitamin D supplements.

Canasa

Dear @Name@,

Your doctor has discussed the following subject with you: Canasa. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a suppository to deliver the medicine directly to the lower portion of your colon. The suppository is inserted directly into the rectum, and does not need to be passed or removed. The suppository should remain in the colon for at least 20 to 40 minutes.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Cimzia (certolizumab)

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Cimzia (certolizumab)

Dear @Name@,

Your doctor has discussed the following subject with you: Cimzia. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • This medication is also considered an anti-TNF drug, which means that it targets a specific protein in your body called tumor necrosis factor (TNF) that causes inflammation in your intestines.
  • It is given as an injection under the skin of your belly or thigh. The injection process takes about 10 seconds. A doctor or nurse will teach you how to do the injection. Once you learn how to do it yourself, you or a family member can do at home.
  • Your doctor may adjust the dose and how often you receive it, but typically it is given once every 4 weeks.
  • It may take up to 8 weeks after starting this medication to see an improvement in your symptoms. However, a lot of people see more immediate improvement.
  • Side effects can include injection site reactions (such as redness, rash, swelling, itching, pain, or bruising), upper respiratory infections (including sinus infections), headaches, and nausea. There have been reports of serious infections, including tuberculosis. Anti-TNF medications have been associated with a small risk of lymphoma, an uncommon cancer.
  • Be sure to get tested for tuberculosis and Hepatitis B before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Cipro (ciprofloxacin)

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Cipro (ciprofloxacin)

Dear @Name@,

Your doctor has discussed the following subject with you: Cipro.  Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called antibiotics.
  • Antibiotics are mostly used to treat infections inside the body, but can be used to reduce irritation and inflammation in the intestines.  It can also be used to treat disease complications (like abscesses or fistulas) and can be given after surgery.
  • It is usually given as a pill, but can sometimes be given as an intravenous injection.
  • Antibiotics are generally well tolerated by the body, but may cause side effects such as nausea, vomiting, loss of appetite, rash, diarrhea, dizziness, and headaches.
  • This medication may cause pain and inflammation of your tendons, particularly in your Achilles tendon (the tendon that connects your calf muscle to the heel of your foot).
  • This medication can become less effective if taken with antacids (such as Rolaids and Tums) as well as calcium, iron, or zinc vitamin/mineral supplements.
  • Avoid the sun while on this medication.  Wear sunscreen during the day, and avoid tanning booths.
  • Before taking these medications, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed.  Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again.  Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Colocort (hydrocortisone)

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Colocort (hydrocortisone)

Dear @Name@,

Your doctor has discussed the following subject with you: Colocort. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given as an enema to reduce inflammation in the anus, rectum or the last part of large intestine.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Long-term use can result in a weakening of the muscles in the anus and rectum.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Colorectal Cancer

Dear @Name@,

Your doctor has discussed the following subject with you: colorectal cancer . Here is some additional information. Let us know if you have any questions regarding this information.

Colorectal cancer can occur anywhere in the large intestine (colon and rectum). Chronic inflammation of the colon can damage the lining of the colon over time, leading to an increased risk of colorectal cancer. Therefore, people with ulcerative colitis and Crohn's disease involving the colon are at an increased risk of developing colorectal cancer. However, the risk usually does not begin to increase until 8-10 years after developing ulcerative colitis or Crohn's disease involving the colon. It is important to know that colorectal cancer is preventable and highly treatable in the early stages.

The risk for colorectal cancer can be reduced by keeping your inflammatory bowel disease (IBD) under control. However, this does not eliminate the risk entirely. Therefore, it is recommended that you get a colonoscopy every 1-2 years beginning 8-10 years after your IBD symptoms initially appeared. The colonoscopy allows your doctor to find and remove pre-cancerous tissue.

Colorectal cancer can have symptoms, but can also be completely without symptoms. If you experience any of the following symptoms, talk to your doctor immediately: abdominal pain, bleeding, a change in the number of bowel movements or their consistency, tiredness, or weight loss.

For further information, please check out http://www.crohnscolitisfoundation.org/resources/colorectal-cancer.html or follow this link:

Cortenema (hydrocortisone)

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Cortenema (hydrocortisone)

Dear @Name@,

Your doctor has discussed the following subject with you: Cortenema. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given as an enema to reduce inflammation in the anus, rectum or the last part of large intestine.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Long-term use can result in a weakening of the muscles in the anus and rectum.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Corticosteroids

Dear @Name@,

Your doctor has discussed the following subject with you: corticosteroids. Here is some additional information. Let us know if you have any questions regarding this information.

  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Budesonide is a type of steroid that is targeted to the intestine. The liver breaks it down before it affects the rest of the body, so it usually has fewer side effects than other corticosteroids.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Cortifoam (hydrocortisone)

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Cortifoam (hydrocortisone)

Dear @Name@,

Your doctor has discussed the following subject with you: Cortifoam. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given as a foam to reduce inflammation in the anus, rectum or the last part of large intestine.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Long-term use can result in a weakening of the muscles in the anus and rectum.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Deltasone (prednisone)

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Deltasone (prednisone)

Dear @Name@,

Your doctor has discussed the following subject with you: Deltasone. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given as a pill.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Delzicol (mesalamine)

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Delzicol (mesalamine)

Dear @Name@,

Your doctor has discussed the following subject with you: Delzicol. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • It is important to take the pill with plenty of water.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Entocort (budesonide)

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Entocort (budesonide)

Dear @Name@,

Your doctor has discussed the following subject with you: Entocort. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines.
  • This medication is given as a pill.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Budesonide (Entocort) is a type of steroid that is targeted to the intestine. The liver breaks it down before it affects the rest of the body, so it usually has fewer side effects than other corticosteroids.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Entyvio (vedolizumab)

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Entyvio (vedolizumab)

Dear @Name@,

Your doctor has discussed the following subject with you: Entyvio. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • This medication is also considered an integrin receptor antagonist.
  • It is injected into a vein in a procedure called an infusion. The infusion is given at a certified infusion center and lasts approximately 30 minutes.
  • Your doctor may adjust the dose and how often you receive it, but typically it is given once every 8 weeks.
  • Side effects can include common cold, headache, joint pain, nausea, and fever. An allergic reaction can happen during or after the infusion (rash; itching; swelling of lips, tongue, throat or face; shortness of breath; heart palpitations), there have been reports of infections, and liver problems can occur.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Eye Complications

Dear @Name@,

Your doctor has discussed the following subject with you: eye complications. Here is some additional information. Let us know if you have any questions regarding this information.

Approximately 10% of people with inflammatory bowel disease (IBD) experience eye problems. However, most of these are treatable and do not pose any significant threat to loss of vision. Therefore, a regular examination by an ophthalmologist (a doctor who specializes in diseases of the eye) is very important. Also, it is not only the IBD itself that may cause eye disorders; sometimes the medications used to treat the disease can affect the eyes. For example, long-term use of corticosteroids may lead to glaucoma and cataracts (clouding of the lens of the eye that impairs vision).

If you notice any type of eye irritation or inflammation, bring it to your doctor's attention immediately.

Fistula

Dear @Name@,

Your health care provider has discussed the following subject with you: intestinal fistula of Crohn’s disease. Here is some additional information. Let us know if you have any questions regarding this information.

Crohn’s disease is a chronic inflammatory disease of the bowel that can involve any area from the mouth to the anus, and can affect the entire thickness of the GI tract.

Crohn’s disease may result in fistulas. A fistula is an abnormal connection between two areas. These are thought to form when inflammation extends into the area surrounding the bowel wall. Fistulae can develop between two GI organs (for example, the small intestine and the large intestine), between GI organs and the bladder, between GI organs and the vagina, and between GI organs and the skin. The most common location for these fistulae is, again, the ileum (the last part of the small intestine). A unique kind of fistula in Crohn’s disease is a perianal fistula, which connects the inside lining of the rectum (the last part of the colon) with the skin surrounding the anus.

Depending on which organs are connected by fistulae, patients can have different symptoms. Fistulae between the small and large intestine can cause diarrhea or passage of undigested foods. Fistulae between the intestine and bladder can result in urinary tract infections, with symptoms of burning with urination, cloudy urine, or blood in the urine. Fistulae to the vagina can result in passage of gas or stool through the vagina. Finally, fistulae to the skin can initially present as a painful bump or boil (called an abscess) that then opens up and drains fluid or stool. To treat fistulae, there are medical options (if there is also a significant amount of inflammation, oftentimes including antibiotics) and surgical options (especially if strictures recur frequently).

Flagyl (metronidazole)

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Flagyl (metronidazole)

Dear @Name@,

Your doctor has discussed the following subject with you: Flagyl.  Here is some additional information. Let us know if you have any questions regarding this information. 

  • This medication belongs to a class of drugs called antibiotics.
  • Antibiotics are mostly used to treat infections inside the body, but can be used to reduce irritation and inflammation in the intestines.  It can also be used to treat disease complications (like abscesses or fistulas) and can be given after surgery.
  • It is usually given as a pill, but can sometimes be given as an intravenous injection.
  • Antibiotics are generally well tolerated by the body, but may cause side effects such as nausea, vomiting, loss of appetite, rash, diarrhea, dizziness, and headaches.
  • This medication may cause a metallic taste in your mouth and dark or reddish urine.  These symptoms go away when the medication is stopped.
  • When used for a long time, it can cause a tingling in the hands and feet (neuropathy).  If this happens, tell your doctor immediately.
  • Avoid alcohol when taking this medication, and for at least two days following your last dose.
  • Before taking these medications, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed.  Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again.  Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately. 

Humira (adalimumab)

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Humira (adalimumab)

Dear @Name@,

Your doctor has discussed the following subject with you: Humira. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • This medication is also considered an anti-TNF drug, which means that it targets a specific protein in your body called tumor necrosis factor (TNF) that causes inflammation in your intestines.
  • It is given as an injection under the skin of your belly or thigh. The injection process takes about 10 seconds. A doctor or nurse will teach you how to do the injection. Once you learn how to do it yourself, you or a family member can do at home.
  • Your doctor may adjust the dose and how often you receive it, but typically it is given once every 2 weeks.
  • It may take up to 8 weeks after starting this medication to see an improvement in your symptoms. However, a lot of people see more immediate improvement.
  • Side effects can include injection site reactions (such as redness, rash, swelling, itching, pain, or bruising), upper respiratory infections (including sinus infections), headaches, and nausea. There have been reports of serious infections, including tuberculosis. Anti-TNF medications have been associated with a small risk of lymphoma, an uncommon cancer.
  • Be sure to get tested for tuberculosis and Hepatitis B before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Immunomodulators

Dear @Name@,

Your doctor has discussed the following subject with you: immunomodulators. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Imuran (azathioprine)

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Imuran (azathioprine)

Dear @Name@,

Your doctor has discussed the following subject with you: Imuran. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • With this medication it can take 3 to 6 months to see an improvement of symptoms. Because it may take a while to see an improvement, they are often given along with another faster-acting medication (such as a steroid).
  • Infrequently reported side effects may include headache, nausea, vomiting, diarrhea, tiredness, mouth sores, rash, fever, joint pain, and liver inflammation. Less common side effects include inflammation of the pancreas (pancreatitis), infections, and lymphoma (cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Kidney Complications

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Kidney Complications

Dear @Name@,

Your doctor has discussed the following subject with you: kidney complications. Here is some additional information. Let us know if you have any questions regarding this information.

Some people with inflammatory bowel disease (IBD) may develop kidney complications. These complications are usually caused by the medications you are taking for your IBD. However, once you stop taking the medication, your kidneys usually return back to normal. Because of these potential complications, your kidneys should be continuously monitored by your doctor, regardless of which medication you are taking.

Some kidney complications that occur with IBD include kidney stones and kidney swelling (hydronephrosis). Symptoms of kidney complications could include a sharp pain in the side and back (below the ribs), nausea, vomiting, and blood or puss in the urine. If you experience any of these symptoms, contact you doctor immediately.

Lialda (mesalamine)

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Lialda (mesalamine)

Dear @Name@,

Your doctor has discussed the following subject with you: Lialda. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • It is important to take the pill with plenty of water.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Liver Conditions Associated with IBD

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Liver Conditions Associated with IBD

Dear @Name@,

Your doctor has discussed the following subject with you: liver conditions associated with IBD. Here is some additional information. Let us know if you have any questions regarding this information.

In some people with inflammatory bowel disease (IBD), the liver can become inflamed or injured. Most liver injury is reversible and minor, but major liver injury can affect a small percentage of people with inflammatory bowel disease (IBD). Common symptoms of liver injury include low energy and fatigue. More advanced liver injury can lead to a feeling of fullness or pain in the upper right abdomen, itching, yellowing of the skin or eyes (jaundice), easy bruising, and fluid retention. Remember, having these symptoms does not mean that liver injury has occurred. However, if you experience any of these symptoms, discuss them with your doctor.

Blood tests can be used to detect liver disease. However, an ultrasound, CT scan, MRI, as well as other tests, are often used to confirm the diagnosis. Some liver complications include: fatty liver disease (hepatic steatosis), hepatitis (injury to liver cells), gallstones, and primary sclerosing cholangitis, also known as PSC (an autoimmune disease associated with IBD). Each liver complication is treated differently. In some cases, your doctor may recommend seeing a liver specialist (hepatologist).

Medrol (Methylprednisone)

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Medrol (Methylprednisone)

Dear @Name@,

Your doctor has discussed the following subject with you: Medrol. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given by IV or by pill.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Methotrexate (MTX, Rhematrex, Mexate)

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Methotrexate (MTX, Rhematrex, Mexate)

Dear @Name@,

Your doctor has discussed the following subject with you: methotrexate . Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • Infrequently reported side effects include flu-like symptoms (nausea, vomiting, headache, fatigue, and diarrhea), mouth sores, and low white blood cell count. Less common side effects include scarring of the liver and lung inflammation. Some of the side effects can be prevented by adding folic acid (a vitamin).
  • Should be avoided by pregnant women. If you would like to become pregnant, this medication should be avoided by both men and women several months before pregnancy.
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Neoral (cyclosporine)

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Neoral (cyclosporine)

Dear @Name@,

Your doctor has discussed the following subject with you: Neoral. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • With this medication you can begin to see improvement of symptoms in 1 to 2 weeks.
  • Infrequently reported side effects include decreased kidney function, hepatitis, infections, diabetes, increased cholesterol, sleep problems, headache, mild tremors, seizure, high blood pressure, swollen gums, tingling of the fingers and feet, increased facial hair, and a small increase in the risk of lymphoma (a cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the kidneys.
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Nutrition

Dear @Name@,

Your provider has discussed the following subject with you: subject. Here is some additional information. Please be sure to follow up with your provider with any questions and discuss the findings of any testing being done to ensure you are not at risk for malnourishment.

People with Crohn's disease and ulcerative colitis may have difficulty maintaining healthy nutrition for a variety of reasons, including disease symptoms, complications, and medications. During times of disease flares, diarrhea, urgency to have a bowel movement, abdominal pain, nausea, vomiting, blood in the stool, constipation, loss of appetite, fatigue and weight loss can negatively impact nutrition. Severe diarrhea can cause dehydration, robbing the body of fluids, nutrients and electrolytes (sodium, potassium, magnesium and phosphorus).

People with Crohn's disease and ulcerative colitis often have a reduced appetite as a result of nausea, abdominal pain or altered taste sensation. This can make it difficult to consume enough calories and obtain sufficient nutrients. Additionally, the need to have numerous bowel movements in a day may cause a person with Crohn's disease and ulcerative colitis to shy away from eating too much to avoid symptoms. Eating too little puts people at risk for being malnourished.

It's important to consider and assess whether you are experiencing malabsorption of nutrients, decreased bone mineral density, and/or whether you would benefit from vitamin or mineral supplements or referral to a dietician. The Crohn's & Colitis Foundation offers a Diet, Nutrition and Inflammatory Bowel Disease brochure that covers the impact of IBD on maintaining healthy nutrition, including guidance on what foods are high in certain vitamins and minerals and explanations of supplementation.

Please be sure to follow up with your provider with any questions and discuss any findings of any testing being done to ensure you are not at risk for malnourishment.

Your provider can also discuss the Crohn's & Colitis Foundation's IBD Nutrition Care Pathway with you at your next visit. The pathway uses guideline recommendations to identify and manage malnourishment.

This resource is supported by an independent medical educational grant from Nestlé Health Science

Olsalazine (Dipentum)

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Olsalazine (Dipentum)

Dear @Name@,

Your doctor has discussed the following subject with you: Olsalazine. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • Diarrhea is the most common side effect. However, it can usually be reduced by taking the medication with food.
  • Rare side effects are hair loss, inflammation of the pancreas (pancreatitis), and inflammation of the tissue around the heart (pericarditis).
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Pentasa (mesalamine)

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Pentasa (mesalamine)

Dear @Name@,

Your doctor has discussed the following subject with you: Pentasa. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • It is important to take the pill with plenty of water.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Prograf (tacrolimus)

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Prograf (tacrolimus)

Dear @Name@,

Your doctor has discussed the following subject with you: Prograf. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • Infrequently reported side effects include decreased kidney function, hepatitis, infections, diabetes, increased cholesterol, sleep problems, headache, mild tremors, seizure, high blood pressure, swollen gums, tingling of the fingers and feet, increased facial hair, and a small increase in the risk of lymphoma (a cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the kidneys, bone marrow, and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Purinethol (6-mercaptopurine)

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Purinethol (6-mercaptopurine)

Dear @Name@,

Your doctor has discussed the following subject with you: Purinethol. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • Infrequently reported side effects may include headache, nausea, vomiting, diarrhea, tiredness, mouth sores, rash, fever, joint pain, and liver inflammation. Less common side effects include inflammation of the pancreas (pancreatitis), infections, and lymphoma (cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Remicade (infliximab)

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Remicade (infliximab)

Dear @Name@,

Your doctor has discussed the following subject with you: Remicade. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • This medication is also considered an anti-TNF drug, which means that it targets a specific protein in your body called tumor necrosis factor (TNF) that causes inflammation in your intestines.
  • It is injected into a vein in a procedure called an infusion. The infusion is given at a certified infusion center and lasts approximately 2 to 4 hours.
  • Your doctor may adjust the dose and how often you receive it, but typically it is given once every 8 weeks.
  • It may take up to 8 weeks after starting this medication to see an improvement in your symptoms. However, a lot of people see more immediate improvement.
  • During the infusion (less than 24 hours after the infusion) some patients experience a reaction, which can include fever, chest pain, heart palpitations, sweating, nausea, flushing, itching, changes in blood pressure, and difficulty breathing. These reactions usually go away by slowing the rate of the infusion or taking medications such as acetaminophen, anti-histamines, steroids, or epinephrine. If you experience any of these during the infusion, let your doctor know immediately. Your doctor will likely recommend you take these medications before your next infusion to decrease the possibility of having another reaction.
  • A reaction can occur after the infusion (24 hours to 14 days after infusion) as well. Symptoms may include muscle or joint aches, itching, rash, fever, and fatigue. If you experience any of these symptoms, tell your doctor immediately. These symptoms may go away by taking acetaminophen, anti-histamines, or steroids. Your doctor will likely recommend you take these medications before your next infusion to decrease your possibility of having another reaction.
  • There have been reports of serious infections, including tuberculosis. Anti-TNF medications have been associated with a small risk of lymphoma, an uncommon cancer.
  • Be sure to get tested for tuberculosis and Hepatitis B before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Rowasa (mesalamine)

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Rowasa (mesalamine)

Dear @Name@,

Your doctor has discussed the following subject with you: Rowasa. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a liquid enema to deliver the medicine directly to the lower portion of your colon. The liquid enema is inserted directly into the rectum, and should remain in the colon for at least 20-40 minutes.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Sandimmune (cyclosporine)

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Sandimmune (cyclosporine)

Dear @Name@,

Your doctor has discussed the following subject with you: Sandimmune. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called immunomodulators. It helps to reduce irritation and swelling (inflammation) in the intestines. It also decreases the long-term need for steroids. For that reason, it is sometimes referred to as a "steroid-sparing" drug. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • With this medication you can begin to see improvement of symptoms in 1 to 2 weeks.
  • Infrequently reported side effects include decreased kidney function, hepatitis, infections, diabetes, increased cholesterol, sleep problems, headache, mild tremors, seizure, high blood pressure, swollen gums, tingling of the fingers and feet, increased facial hair, and a small increase in the risk of lymphoma (a cancer of the lymph nodes).
  • Blood tests should be performed frequently to check for medication effects on the kidneys.
  • Blood tests should be performed frequently to check for medication effects on the bone marrow and liver.
  • Women who are pregnant or wish to become pregnant should talk to their doctor before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Short Bowel

Dear @Name@,

Your doctor has discussed the following subject with you: short bowel. Here is some additional information. Let us know if you have any questions regarding this information.

Short bowel syndrome (SBS) is a disorder that affects people who are unable to use large portions of their small intestine as a result of a digestive illness, such as Crohn's disease. Parts of the small intestine can become unusable due to injury or disease, or if large portions of it are surgically removed. When large amounts of functional small intestine are missing, the body is unable to absorb adequate amounts of nutrients, vitamins, and water from food to stay healthy.

The most common symptom of short bowel syndrome is diarrhea, which may lead to dehydration, malnutrition, and weight loss. Additional symptoms could include abdominal pain and cramping, anemia, bloating, easy bruising, fragile or thin bones, foul-smelling or oily stools, and weakness. Particular mineral/vitamin deficiencies can be linked to the specific section of the small intestine that is damaged or was removed.

For some people, short bowel syndrome is a temporary problem, and the remaining small intestine adjusts for the missing segments. However, it can take as long as two years for the small intestine to make this adaption. Therefore, treatment is typically necessary during this interval and varies depending on the amount and section of the remaining small intestine, the severity of the associated symptoms, and how well the body adapts over time.

The first treatment step is typically dietary adjustments that could include a change in diet, electrolyte/nutrition supplements, mineral/vitamin supplements, and oral rehydration solutions. Medications may also be used to relieve symptoms, including anti-diarrheals, gastric acid reducers, GLP-2, L-glutamine powder, and somatropin. In some cases, nutrition may need to be delivered through a feeding tube (enteral nutrition) or through a vein (parenteral nutrition).

Simponi (golimumab)

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Simponi (golimumab)

Dear @Name@,

Your doctor has discussed the following subject with you: Simponi. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • This medication is also considered an anti-TNF drug, which means that it targets a specific protein in your body called tumor necrosis factor (TNF) that causes inflammation in your intestines.
  • It is given as an injection under the skin of your belly or thigh. The injection process takes about 10 seconds. A doctor or nurse will teach you how to do the injection. Once you learn how to do it yourself, you or a family member can do at home.
  • Your doctor may adjust the dose and how often you receive it, but typically it is given once every 4 weeks.
  • It may take up to 8 weeks after starting this medication to see an improvement in your symptoms. However, a lot of people see improvements much faster.
  • Side effects can include injection site reactions (such as redness, rash, swelling, itching, pain, or bruising), upper respiratory infections (including sinus infections), headaches, and nausea. There have been reports of serious infections, including tuberculosis. Anti-TNF medications have been associated with a small risk of lymphoma, an uncommon cancer
  • Be sure to get tested for tuberculosis and Hepatitis B before taking this medication.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Skin Complications

Dear @Name@,

Your doctor has discussed the following subject with you: skin complications. Here is some additional information. Let us know if you have any questions regarding this information.

Some people with inflammatory bowel disease (IBD) may get complications outside of their intestines, including their skin. These skin issues are usually linked to how active your IBD is. For example, they generally appear right before or during a disease flare. These complications usually heal when your IBD is brought under control with medications. However, antibiotics and skin ointments may also be prescribed. The most common skin complications experienced by those with IBD include:

Erythema nodosum: With this complication, tender red bumps usually appear on the shins and ankles, but can sometimes appear on the arms.

Pyoderma gangrenousm: Is usually found on the shins and ankles, but can sometimes appear on the arms. They typically begin as small blisters that eventually join together to form deep ulcers.

If you experience any of these symptoms, or any changes to your skin, talk to your doctor about your concerns.

Solumedrol (Methylprednisone)

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Solumedrol (Methylprednisone)

Dear @Name@,

Your doctor has discussed the following subject with you: solumedrol. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines and throughout the body, including joints, skin, and eyes.
  • This medication is given by IV or by pill.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Stelera - Ustekinumab

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Stelera - Ustekinumab

Dear @Name@,

Your healthcare provider has discussed the following medical therapy with you: Stelara (ustekinumab). Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologic therapies (protein-based therapies). It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, it may be necessary to combine this medication with another medication to control inflammation.

  • This medication binds and blocks two inflammatory proteins, interleukin 12 and 23, that can lead to inflammation associated with Crohn’s disease.

  • The initial dose is injected into a vein in a procedure called an infusion. The infusion is given at a certified infusion center and lasts approximately one hour.

  • During the infusion (and less than 24 hours after the infusion), a few patients may experience a mild reaction, which can include itching, flushing and rare hives. These symptoms can usually be treated by slowing the rate of the infusion or taking medications such as acetaminophen, anti-histamines, steroids, or epinephrine. If you experience any of these during the infusion, let your healthcare provider know immediately.

  • A reaction can occur after the infusion (24 hours to 14 days after infusion) as well. These symptoms may be treated by taking acetaminophen, anti-histamines, or steroids.

  • The maintenance treatment is given as a self-administered injection under the skin, typically once every eight weeks; however, some patients may require more frequent dosing depending on their response.

  • It may take up to six to eight weeks after starting this medication to see an improvement in your symptoms.

  • The most common side effects seen in the clinical trials for Stelara in Crohn’s disease patients were nasopharyngitis (throat infection), vaginal yeast infection, bronchitis, itching, urinary tract infection, and sinusitis.

  • Live vaccines (especially the live shingles vaccine) should not be given once you have started taking Stelara. There is a non-live vaccine for shingles – be sure to discuss this further with your healthcare provider.

  • There is also a small increased risk of squamous cell skin cancers. There may be an increased risk of cancers in general, but the actual risk is not yet known and likely quite small.

  • Before taking this medication, let your healthcare provider know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.

  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication, or how frequently you take it, unless directed by your healthcare provider.

  • If you have any side effects or you continue to have symptoms, speak to your healthcare provider immediately.

 

Strictures

Dear @Name@,

Your health care provider has discussed the following subject with you: intestinal strictures of Crohn’s disease. Here is some additional information. Let us know if you have any questions regarding this information.

Crohn’s disease is a chronic inflammatory disease of the bowel that can involve any area from the mouth to the anus, and can affect the entire thickness of the GI tract.

Crohn’s disease may result in strictures. A stricture is an area of narrowing in the intestines. After repeated cycles of continued inflammation and healing in the lining of the intestine, scar tissue can replace the normal cells. As a result, this scar tissue may result in narrowing of the gastrointestinal tract. Occasionally, this narrowing can get so severe that it can cause bowel obstruction. The most common locations for these strictures are the ileum (the last part of the small intestine) and the ileocecal valve (the entrance from small to large intestine), although strictures can also be seen in the upper gastrointestinal tract, colon, rectum, or anus.

Depending on where the stricture is located, patients with strictures can have blockage symptoms that include nausea and vomiting, abdominal pain, bloating, or the inability to pass gas and stool. Let your doctor know if you have any of these symptoms. To diagnose strictures, colonoscopy and CT scans or MRIs of the abdomen can be used. To treat strictures, there are medical options (if there is also a significant amount of inflammation) and surgical options (especially if strictures recur frequently).

Sulfasalazine (Azulfidine)

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Sulfasalazine (Azulfidine)

Dear @Name@,

Your doctor has discussed the following subject with you: sulfasalazine. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called aminosalicylates, which are also known as 5-ASAs. It helps to reduce the irritation and swelling (inflammation) in the lining of the intestines.
  • If taken as prescribed, these medications can work as quickly as 2 to 4 weeks.
  • The benefit of taking this medication is that it is generally well tolerated and has not been associated with an increased risk for infection or cancer. However, in some cases, it may cause headache, nausea, abdominal pain and cramping, loss of appetite, vomiting, rash, fever, or diarrhea. It is rare that this medication causes injury to your pancreas or kidneys. However, those with kidney problems should not use this medication. Your health care provider will be monitoring your kidney function annually.
  • If you have unpleasant side effects or you continue to have symptoms, speak to your doctor immediately.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • Taken as a pill.
  • If you have a sulfa allergy, you should not take this medication.
  • This medication should be given in combination with folic acid daily.
  • For men, this medication can cause a decrease in sperm production and function. However, sperm count becomes normal once you stop taking the medication.
  • If you are planning to have a child, speak with your healthcare provider before taking this medication.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.

Tysabri (natalizumab)

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Tysabri (natalizumab)

Dear @Name@,

Your doctor has discussed the following subject with you: Tysabri. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called biologics. It helps to reduce irritation and swelling (inflammation) in the intestines. In some cases, this medication is used by itself. In other cases, this medication is used together with another medication to achieve better results.
  • This medication is also considered an integrin receptor antagonist.
  • It is injected into a vein in a procedure called an infusion. The infusion is given at a certified infusion center and lasts approximately 1 hour.
  • Your doctor may adjust the dose and how often you receive it, but typically it is given once every 4 weeks.
  • Side effects can include urinary tract infections, upper respiratory infections, headache, tiredness, depression, joint paint, diarrhea, and stomach pain.
  • It carries an increased risk of a severe brain condition called progressive multifocal leukoencephalopathy (PML), which can be caused by the John Cunningham (JC) virus. It is important to be tested for JC virus prior to starting this medication. Patients who are negative for the JC virus have a much lower risk of developing PML.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Uceris (budesonide-MMX)

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Uceris (budesonide-MMX)

Dear @Name@,

Your doctor has discussed the following subject with you: Uceris. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called corticosteroids.
  • These powerful and fast-acting medications help reduce irritation and swelling (inflammation) in the intestines.
  • This medication is given as a pill or foam.
  • You should notice an improvement of symptoms within days of starting this medication.
  • While steroids can be used for weeks or months, they should only be used for short periods of time because of their side effects. Steroids can be used to get you well in the short term, but should never be a long term maintenance medication.
  • Budesonide (Uceris) is a type of steroid that is targeted to the intestine. The liver breaks it down before it affects the rest of the body, so it usually has fewer side effects than other corticosteroids.
  • Side effects can include yeast infections (in the mouth or female reproductive organs), urinary tract infections, high blood pressure, high blood sugar levels, weight gain, stretch marks, acne, rounding of the face (moon face), facial hair, difficulty sleeping, mood swings, and psychiatric symptoms. These side effects will usually go away when the medication is stopped. Long-term use of steroids can result in a weakening of the bones (osteoporosis) and cataracts.
  • Before taking this medication, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Vancocin (Vancomycin)

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Vancocin (Vancomycin)

Dear @Name@,

Your doctor has discussed the following subject with you: Vancocin. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called antibiotics.
  • Antibiotics are mostly used to treat infections inside the body, but can be used to reduce irritation and inflammation in the intestines. It can also be used to treat disease complications (like abscesses or fistulas) and can be given after surgery.
  • It is usually given as a pill, but can sometimes be given as an intravenous injection.
  • Antibiotics are generally well tolerated by the body, but may cause side effects such as nausea, vomiting, loss of appetite, rash, diarrhea, dizziness, and headaches.
  • This medication may cause a redness of the skin and itching on the face, neck, and upper body.
  • Before taking these medications, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

Xeljanz - Tofacitinab

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Xeljanz - Tofacitinab

Dear @Name@,

Your health care provider has discussed the following subject with you: Xeljanz (tofacitinib). Here is some additional information regarding this medical therapy. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called Janus kinase inhibitors, which block the enzyme Janus kinase (also known as JAK) and prevent the activation of certain types of immune cells that cause inflammation. It helps to reduce irritation and swelling (inflammation) in the intestines. In most cases, this medication is used by itself, with no other immunosuppressive treatments.

  • The medication is taken by mouth twice a day.

  • The initial dose (used for eight weeks) can be higher or the same as the maintenance dose.

  • It may take up to six to eight weeks after starting this medication to see an improvement in your symptoms, though improvement can be seen as late as four months after starting.

  • You will require frequent laboratory monitoring while taking this therapy.

  • The most common side effects in patients taking Xeljanz in the clinical trials for ulcerative colitis were headache, common cold (upper respiratory infection), and nasopharyngitis (sinus/throat infection).

  • There have been reports of serious infections such as herpes zoster or shingles with Xeljanz. There is also a theoretical risk of perforation, though this has not been observed in the population with ulcerative colitis.

  • Live vaccines (especially the live shingles vaccine, Zostavax) should not be given once you have started Xeljanz. There is a new non-live vaccination for shingles, Shingrix, which you could discuss further with your health care provider.

  • Before taking this medication, let your doctor know about other medical conditions that you may have, or other medications (even over-the-counter medications or alternative therapies) you may be taking.

  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication, or how frequently you take it, on your own.

  • If you have any side effects or you continue to have symptoms, speak to your health care provider immediately.

  •  

Xifaxan (rifaximin)

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Xifaxan (rifaximin)

Dear @Name@,

Your doctor has discussed the following subject with you: Xifaxan. Here is some additional information. Let us know if you have any questions regarding this information.

  • This medication belongs to a class of drugs called antibiotics.
  • Antibiotics are mostly used to treat infections inside the body, but can be used to reduce irritation and inflammation in the intestines. It can also be used to treat disease complications (like abscesses or fistulas) and can be given after surgery.
  • It is usually given as a pill, but can sometimes be given as an intravenous injection.
  • Antibiotics are generally well tolerated by the body, but may cause side effects such as nausea, vomiting, loss of appetite, rash, diarrhea, dizziness, and headaches.
  • This medication may cause muscle tightening and joint pain.
  • Should be used with caution if taking while pregnant.
  • Before taking these medications, let your doctor know about other medical conditions that you may have or other medications (even over-the-counter medications or alternative therapies) you may be taking.
  • The best way to control your disease is by taking your medication as directed. Even when you do not have any symptoms, it is very important to continue taking your medication to prevent your disease from becoming active again. Do not alter the amount of the medication or how frequently you take it on your own.
  • If you have any side effects or you continue to have symptoms, speak to your doctor immediately.

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