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IBD self help

Self Help- how to manage a flare of Ulcerative Proctitis

What Is a Flare of Proctitis?


A flare is the reappearance of the characteristic symptoms of ulcerative colitis. Ulcerative proctitis is disease limited to the rectum. . A flare may be an uncomfortable but expected part of having ulcerative proctitis. People with ulcerative proctitis go through periods when the disease is quiet and few or no symptoms are present, alternating with times when it is active and causing symptoms. Medical treatment for ulcerative proctitis is aimed at bringing the conditions into a state of remission (no active disease or symptoms) and keeping it that way for as long as possible. There is always the possibility, though, that the disease may flare up at times.  Proctitis may flare up for no apparent reason. However, some possible triggers for recurrence of symptoms have been identified. These include:


  •  Lapses in taking medications/incorrect dosing of medications
  • Recent use of certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs, Aspirin, Ibupfrofen ) or antibiotics.


During a flare-up of Proctitis SYMPTOMS MAY INCLUDE.


  • bleeding from the rectum or blood in the stool
  • passing mucus
  • diarrhea
  • inability to have a satisfactory bowel movement- Partially formed (or completely unformed) stools
  • Urgency
  • frequently feel an urgent need to have a bowel movement


The key to managing an ulcerative proctitis flare is to get treatment as soon as possible

If you think you are having a flare-up your Proctitis you can increase your mesalazine suppositories or enemas to the maximum daily dose.

You can use your prescribed  suppositories or enemas daily, as discussed with your specialist nurse.

Increase medication as follows:

Liquid enema preparation:

  •  Pentasa 1g Liquid enema- Once daily
  • Salofalk 2g Liquid enema- Once daily


Foam enema preparations:

  • Asacol 1g Foam enema-1g Morning and evening
  • Salofalk 1g Foam enema- 1g Morning and Evening



  • Asacol 500mg Suppositories- 500mg Morning, Afternoon and Evening
  • Pentasa 1g Suppository- 1g Once daily
  • Salofalk 500mg Suppository- 500mg Morning, Afternoon and Evening
  • Salofalk 1g Suppository- 1g Once daily

Please ensure you check the dosage of your medication


If you see no improvement within 1 week or your symptoms worsen please contact your Specialist nurse or consultant.

If you experience high fever, severe abdominal pain, vomiting, diarrhoea and bleeding seek medical advice.


'In recent times, I have utilised admissions to Richardson for respite direct from my fracture clinic, even at weekends. I have never worked anywhere with this efficiency before - it is reassuring and invaluable for the patient.'

Patient, Lowson / Starling Wards, Richardson Hospital