Managing Symptoms of Ulcerative Colitis - Diarrhoea: exclude alternative cause e.g. infection, abscess, dysmotility, bacterial overgrowth, bile salt malabsorption.
Diarrhoea secondary to drug treatment e.g. exclude laxative iron supplements, antibiotic, or methotrexate.
Do not prescribe anti-motility drugs e.g. loperamide as can increase risk of toxic megacolon.
Offer sources of information.
Constipation - Assess for bowel obstruction.
If unlikely bowel obstruction - ensure diet /fluids and soluble fibre intake.
If symptoms persist offer bulk forming laxative e.g. Ispaghula husk.
Abdominal pain - identify cause. Persistent/recurrent pain common in ulcerative colitis cause may be exacerbations/poor disease control/intestinal dilation/bowel obstruction or adhesions . Offer symptom relief analgesia. avoid NSIAD, Opiate analgesia may increase risk of toxic magacolon