Your complete reference for Crohn's and colitis.
Understand your disease, follow your treatment, walk into your appointment prepared.
Everything a person with Crohn's disease or ulcerative colitis needs in one place: the difference between them, diagnosis, the treatment map with every medicine and its schedule, calprotectin explained, flares, pregnancy, vaccinations and surveillance colonoscopy. Then the Hadaa tools to follow your treatment day by day.
- Understand10 reference sections
- Know your medicines16 medicines with schedules
- DecideWhen to contact your team
- FollowHadaa tools
Do not wait if: Opening your bowels six or more times a day, Blood in the stool that is becoming clearer and heavier, High temperature, A fast or irregular heartbeat, Shortness of breath. These are signs of a severe flare that may need hospital admission. Contact your doctor or IBD team at once, or emergency services if you cannot reach them.
Medical supervisor of SADA: د. الفضل عبدالفتاح، استشاري الجهاز الهضمي والقولون والمستقيم. Scope of medical review
Remission has three levels: quiet symptoms, quiet tests, healed lining. Ask your doctor which level you are at.
The goal of treatment: remission, then keeping it →One fact a day from the centre. Come back tomorrow for a new card.Understand Crohn's and colitis
Open any section for the explanation and its sources. Each one is written to be the last thing you need to read on its topic.
Crohn's and ulcerative colitis: alike and differentBoth are long-term inflammation of the digestive tract. Crohn's disease can affect any part of it and most often appears between 20 and 29. Ulcerative colitis causes inflammation and ulcers in the inner lining of the colon and most often appears between 15 and 30.
The exact cause is unknown; genes, the immune response, gut microbes and the environment are thought to play a part.
In practice: ulcerative colitis starts in the rectum, spreads continuously within the colon and affects the lining only. Crohn's can affect patches in different places and the inflammation may run through the full thickness of the bowel wall, which is why it can cause narrowing (strictures) or fistulas.
Neither disease is contagious, and neither is caused by a particular food or by stress, although both can affect symptoms.
Limits: Telling the two apart and locating the disease is done with tests and endoscopy with your doctor.
Sources: NIDDK (2024) · NIDDK (2020)
Symptoms, and how the diagnosis is confirmedSymptoms vary from person to person and include diarrhoea, abdominal pain and weight loss, with blood in the stool in ulcerative colitis.
Symptoms can appear outside the gut: joint pain, mouth ulcers, skin rashes, red eyes and fatigue. They are not necessarily "something else"; tell your team about them.
Diagnosis does not usually rest on one test but on your history, examination, blood and stool tests and endoscopy.
The usual tools: a stool test that rules out infection and measures calprotectin, blood tests for inflammation and anaemia, colonoscopy with biopsies, and small-bowel imaging (MRI or ultrasound) when Crohn's outside the colon is suspected.
Limits: Symptoms alone are not enough for a diagnosis.
Sources: NIDDK (2024) · NIDDK (2020) · Crohn's & Colitis UK (2024)
The goal of treatment: remission, then keeping itMedicines are used to reduce inflammation, bring the disease into remission and then keep it there and prevent flares. Surgery may be an option in some situations or complications.
Remission has levels: first symptoms settle, then inflammation tests settle (calprotectin and CRP), then the lining heals on endoscopy. Your team checks these targets in order and adjusts treatment when a target is missed; this is called "treat to target".
Another aim is to live without steroids as far as possible: steroids switch off a flare but are not a maintenance treatment.
In Crohn's your doctor may recommend supplements or vitamins if the body does not absorb enough from food. The general advice is a healthy, balanced diet.
Limits: Do not stop or change an immune medicine because symptoms improved without your doctor.
Sources: NIDDK (2024) · NIDDK (2020) · IOIBD — STRIDE-II (2021)
The treatment map: every option in one placeFive families of medicines, and surgery. Your doctor chooses by disease type, location, severity and your history. The table below explains each medicine: how it is given, its usual schedule, the checks before starting, and what to report.
- 5-ASAmild–moderate UC
- Steroidsto end a flare, short course
- Immunomodulatorskeep remission
- Biologicsmoderate–severe, fixed schedule
- Targeted tabletsJAK / S1P, daily
- Surgerycomplications or no response
Aminosalicylates (5-ASA such as mesalazine): first line for mild to moderate ulcerative colitis, as tablets, suppositories or enemas. Of limited use in Crohn's.
Steroids (prednisolone, budesonide): to switch off a flare for a fixed period with a tapering dose; not for maintenance.
Immunomodulators (azathioprine, mercaptopurine, methotrexate): to keep remission and reduce steroid use; they need regular blood tests.
Biologics (infliximab, adalimumab, vedolizumab, ustekinumab and others): antibodies given into a vein or under the skin on a fixed schedule, for moderate to severe disease or when earlier treatment fails.
Small targeted medicines (tofacitinib, upadacitinib, filgotinib, ozanimod, etrasimod): daily tablets acting inside the cell, mostly for ulcerative colitis, some for Crohn's.
Surgery: in ulcerative colitis removing the colon can end the inflammation; in Crohn's it treats strictures, fistulas, abscesses or disease that does not respond.
The medicine map: each medicine, how it is given, and its usual schedule ↓
Limits: The table is educational. The dose and duration on your prescription are the reference and may differ from the usual pattern for reasons specific to you.
Sources: NHS (2023) · NHS (2024) · Crohn's & Colitis UK (2026) · BNF (NICE) (2026)
Understand your tests: calprotectin and moreFaecal calprotectin is a protein released by inflammatory cells in the gut. A high value means gut inflammation, not its type or cause. It is used to follow disease activity between endoscopies.
In practice: below 50 µg/g is usually within the normal range; 50 to 250 is a grey zone where the test is repeated or read with your symptoms; above 250 suggests active inflammation. Laboratories use different cut-offs and your team sets the target that suits you.
The trend matters more than one number: two rises in a row mean more than a single jump after a stomach bug.
CRP in the blood is a general marker of inflammation and can stay normal in some people despite active disease. Other blood tests follow anaemia, iron, vitamin B12 and D, albumin, and liver and kidney safety with some medicines.
With immunomodulators and biologics your doctor may measure the drug level in your blood to decide the dose or the interval between doses.
Limits: Never change a medicine yourself because of a test number.
Sources: Crohn's & Colitis UK (2024) · NICE DG11 (2013) · IOIBD — STRIDE-II (2021)
A flare: how to recognise it, and what to doA flare is the return of symptoms after a quiet period: more bowel movements, blood, urgency, pain, tiredness. Most flares are managed by adjusting treatment early, if you report them early.
First step: contact your team and do not wait for the routine appointment. Do not stop or double your medicine yourself.
The team will usually ask for a stool test to rule out an infection that mimics a flare (such as C. difficile) and to measure calprotectin, plus blood tests.
Drink enough fluids and log the number of bowel movements and any blood day by day; this record speeds up the doctor's decision.
Some painkillers (anti-inflammatories such as ibuprofen) can worsen symptoms; ask before using them.
Limits: The severe-flare signs above call for immediate contact or emergency care.
Sources: nidirect (NHS) (2025) · NHS (2023) · Crohn's & Colitis UK (2024)
Food and daily lifeNo single diet cures the disease. The general advice is a healthy, balanced diet; adjustments may be needed during flares or with a stricture, set by your team.
During a flare, smaller and more frequent meals and temporarily less coarse fibre may help; this is a temporary adjustment, not a permanent diet.
Weight and energy are important markers: unintended weight loss deserves a word with your team and a dietitian.
Smoking makes Crohn's worse and reduces the response to treatment; quitting is one of the most important things you can do for yourself.
The "Your food, your life" program in the Hadaa tools gives home recipes, swaps and a flexible week for stable disease.
Limits: No personalised therapeutic diet comes from this page.
Sources: NIDDK (2024) · NIDDK (2020)
Pregnancy and breastfeedingMost Crohn's and colitis medicines are continued through pregnancy and breastfeeding because active disease is a greater risk to the pregnancy than the medicine. Planning with your team before conceiving is best.
Methotrexate must be stopped before pregnancy for a period your doctor sets, and some small targeted medicines are avoided in pregnancy.
Conceiving during remission lowers the chance of a flare during pregnancy and improves outcomes.
Tell your obstetrician about your medicines, and do not stop anything yourself on learning you are pregnant.
Limits: Medicine decisions in pregnancy are individual and made with the team.
Sources: Crohn's & Colitis UK (2024)
Vaccinations and travelOn immunomodulators, biologics and targeted medicines infections are easier to catch; non-live vaccines are recommended and live vaccines are avoided while immunosuppressed.
Non-live (usually suitable): yearly flu, pneumococcal, COVID-19, hepatitis B, HPV and the non-live shingles vaccine.
Live (usually avoided on immunosuppression): MMR, chickenpox, yellow fever, oral typhoid. Ask your team before travelling to a country that requires a live vaccine.
Before a biologic starts, hepatitis B and C and tuberculosis are usually checked and missing vaccines completed.
When travelling: carry medicines in hand luggage with a prescription in your name, keep injections cooled as the pack says, and take your Hadaa doctor summary with you.
Limits: Your vaccination schedule is set by your team according to your medicines.
Sources: Crohn's & Colitis UK (2024)
Surveillance colonoscopy: when and whyLong-standing inflammation of the colon slightly raises the chance of colon cancer. Surveillance colonoscopy finds early changes and removes them before they progress.
It usually starts about 8 years after symptoms began when inflammation extends beyond the rectum (in ulcerative colitis) or involves a large part of the colon (in Crohn's).
The interval after that is 1 to 5 years depending on risk factors: extent and activity of inflammation, a family history of colon cancer, a stricture or previous changes.
People with primary sclerosing cholangitis (PSC) start surveillance at diagnosis and yearly.
The "My scopes" tool in Hadaa keeps the date of your last colonoscopy and the interval your doctor set, and reminds you of the next one.
Limits: The right interval for you is set by your doctor after each colonoscopy.
Sources: ACG (2019) · BSG (2019)
The medicine map: each medicine, how it is given, and its usual schedule
The schedule shown is the usual licensed adult pattern. Your prescription is the reference and may differ for reasons specific to you. The "My treatment" tool reminds you of the dose your own doctor wrote.
Mesalazine (5-ASA)Aminosalicylates (5-ASA)
- Brand names
- Pentasa, Asacol, Salofalk, Octasa
- Usual schedule
- Tablets or granules daily: usually 2.4–4.8 g/day for a flare and ≥2 g/day for maintenance; suppository or enema at night for rectal or left-sided disease
- Before and during
- Kidney function before starting, then periodically
- Tell your team about
- Rash, chest pain, sudden worsening of diarrhoea
PrednisoloneSteroids
- Usual schedule
- Tablets in the morning: usually 40 mg/day then a gradual taper over about 8 weeks; not for maintenance
- Before and during
- Blood sugar and blood pressure; calcium and vitamin D for bone protection
- Tell your team about
- Mood change, sleep disturbance, hip pain, infection
BudesonideSteroids
- Brand names
- Entocort, Cortiment
- Usual schedule
- Tablets 9 mg each morning for 8 weeks then taper; acts more locally on the gut
- Before and during
- As prednisolone but with fewer effects
- Tell your team about
- As prednisolone
Azathioprine / MercaptopurineImmunomodulators
- Usual schedule
- Daily tablets by weight: azathioprine 2–2.5 mg/kg/day or mercaptopurine 1–1.5 mg/kg/day; takes 8–12 weeks to work
- Before and during
- TPMT enzyme before starting; blood count and liver tests weekly at first then every 3 months; use sunscreen
- Tell your team about
- Fever or sore throat, jaundice, bruising, severe upper abdominal pain
MethotrexateImmunomodulators
- Usual schedule
- Weekly injection (same day each week): usually 25 mg for induction then 15 mg for maintenance in Crohn's, with folic acid on a different day
- Before and during
- Regular blood count, liver and kidney tests; contraception for men and women
- Tell your team about
- New cough or breathlessness, mouth ulcers, fever
InfliximabBiologics
- Brand names
- Remicade, Remsima, Inflectra, Zessly
- Usual schedule
- Intravenous infusion 5 mg/kg at weeks 0, 2 and 6, then every 8 weeks; a subcutaneous form every 2 weeks exists for maintenance
- Before and during
- TB, hepatitis B and C before starting; missing vaccines
- Tell your team about
- Reaction during infusion, infection, persistent cough, new rash
AdalimumabBiologics
- Brand names
- Humira, Amgevita, Hyrimoz, Idacio, Yuflyma
- Usual schedule
- Subcutaneous injection: 160 mg at week 0, 80 mg at week 2, then 40 mg every 2 weeks
- Before and during
- As infliximab
- Tell your team about
- Infection, a large reaction at the injection site, persistent cough
Golimumab (UC)Biologics
- Brand names
- Simponi
- Usual schedule
- Subcutaneous injection: 200 mg at week 0, 100 mg at week 2, then 100 mg every 4 weeks (50 mg if under 80 kg)
- Before and during
- As infliximab
- Tell your team about
- As adalimumab
VedolizumabBiologics
- Brand names
- Entyvio
- Usual schedule
- Intravenous 300 mg at weeks 0, 2 and 6, then every 8 weeks; or subcutaneous 108 mg every 2 weeks for maintenance
- Before and during
- As infliximab; gut-selective, so general infection risk is lower
- Tell your team about
- Infection, severe headache, new joint pain
UstekinumabBiologics
- Brand names
- Stelara, Wezlana, Uzpruvo
- Usual schedule
- One weight-based intravenous induction dose (about 6 mg/kg: 260, 390 or 520 mg), then 90 mg subcutaneously every 8 weeks (or every 12 weeks in Crohn's depending on response)
- Before and during
- As infliximab
- Tell your team about
- Infection, new rash
RisankizumabBiologics
- Brand names
- Skyrizi
- Usual schedule
- Crohn's: intravenous 600 mg at weeks 0, 4 and 8, then 360 mg subcutaneously every 8 weeks. UC: 1200 mg intravenously at weeks 0, 4 and 8, then 180 or 360 mg subcutaneously every 8 weeks
- Before and during
- As infliximab; liver tests
- Tell your team about
- Infection, jaundice, upper abdominal pain
Mirikizumab (UC)Biologics
- Brand names
- Omvoh
- Usual schedule
- Intravenous 300 mg at weeks 0, 4 and 8, then 200 mg subcutaneously every 4 weeks
- Before and during
- As infliximab; liver tests
- Tell your team about
- Infection, jaundice
Tofacitinib (UC)JAK inhibitors
- Brand names
- Xeljanz
- Usual schedule
- Tablets: 10 mg twice daily for 8 weeks, then 5 mg twice daily for maintenance
- Before and during
- Blood lipids, blood count, TB and hepatitis; clot and heart risk assessment over 65 or in smokers
- Tell your team about
- Leg pain or swelling, breathlessness, shingles, infection
UpadacitinibJAK inhibitors
- Brand names
- Rinvoq
- Usual schedule
- Tablets once daily: UC 45 mg for 8 weeks then 15 or 30 mg; Crohn's 45 mg for 12 weeks then 15 or 30 mg
- Before and during
- As tofacitinib
- Tell your team about
- As tofacitinib
Filgotinib (UC)JAK inhibitors
- Brand names
- Jyseleca
- Usual schedule
- Tablets 200 mg once daily
- Before and during
- As tofacitinib
- Tell your team about
- As tofacitinib
Ozanimod / Etrasimod (UC)S1P modulators
- Brand names
- Zeposia, Velsipity
- Usual schedule
- Daily tablets: ozanimod starts with a one-week dose step-up to 0.92 mg/day; etrasimod 2 mg/day
- Before and during
- ECG, eye check and blood count before starting
- Tell your team about
- Slow pulse or dizziness in the first days, change in vision, infection
Sources: Crohn's & Colitis UK (2026) · NHS (2023) · NHS (2024) · BNF (NICE) (2026)
When to contact your team at once
- Opening your bowels six or more times a day
- Blood in the stool that is becoming clearer and heavier
- High temperature
- A fast or irregular heartbeat
- Shortness of breath
These are signs of a severe flare that may need hospital admission. Contact your doctor or IBD team at once, or emergency services if you cannot reach them. Sources: nidirect (NHS) (2025)
Questions to take to your appointment
Hadaa tools and programs: your treatment, tests and scopes in your pocket
Everything above is open to everyone. The tools turn knowledge into daily follow-up, and your data stays on your device.
- "My treatment": your medicines on their real schedule (daily, every 2 weeks, every 8 weeks or induction) with calendar reminders and a "Taken" button.
- "Calprotectin": every result with its date, a colour-coded trend line and an instant comparison with the previous result.
- "My scopes": your last colonoscopy and the interval your doctor set, with an alert before surveillance is due.
- "Today": one minute to log your day, and a weekly strip that warns you early when it looks like a flare.
- "Doctor summary": one page to print or show at your appointment.
- "Your food, your life" program: home recipes, swaps and a flexible week for stable disease (Arabic).
Try the tools now with sample numbers
Bought it before? Open the Hadaa tools · Your food, your life program · Restore my purchases
Educational content from published sources; it does not diagnose and does not replace your doctor. Reference version with all sources (Arabic) · Scope of medical review · Content version 1.0.0.