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IBD flare and NSAIDs — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsIBD flare and NSAIDsGPhC CRA

A 59-year-old man with ulcerative colitis asks for ibuprofen for shoulder pain. He has had bloody diarrhoea for 1 week, CRP is raised on recent GP bloods and he takes mesalazine. What would you advise the patient?

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Correct answer: D — Avoid ibuprofen and seek clinical review for possible IBD flare

NSAIDs can worsen IBD and increase GI adverse effects, and bloody diarrhoea with raised inflammatory markers suggests a possible flare. The patient should be advised to avoid ibuprofen and seek clinical review. Loperamide may be inappropriate in active colitis, particularly with blood. Stopping mesalazine could worsen disease control.

Reference: BNF; NICE CKS Ulcerative colitis