Hydrocortisone rectal foam (Colifoam)

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Hydrocortisone belongs to a class of medicines known as corticosteroids (more commonly called steroids). It reduces inflammation.

You will have been prescribed it to settle symptoms of flare-up inflammation in the lower parts of your bowel.

The leaflet that comes inside your pack will give you full step-by-step instructions for using the foam. Please read it carefully.
Type of medicineA corticosteroid, also commonly called a steroid
Used forInflammation of the rectum and lower colon
Also calledColifoam® (hydrocortisone acetate)
Available asFoam-filled canister with a plastic applicator

Ulcerative colitis (UC) is a condition where patches of inflammation develop in your large intestine. The most common symptoms when the disease flares up are diarrhoea mixed with blood, and tummy (abdominal) pain. In between these flare-ups you may have few or no symptoms. If the patches are confined to the lower parts of your bowel (the lower colon and rectum), it may be helpful during flare-ups for you to be treated with a rectal preparation. This means administering hydrocortisone into your back passage as a foam.

Hydrocortisone helps to reduce inflammation. A course of treatment will last a few weeks only - it will be stopped once your flare-up has settled.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start using hydrocortisone it is important that your doctor knows:

  • If you are pregnant or breast-feeding (even though hydrocortisone could still be prescribed for you).
  • If you think there may be any blockage in your bowel, or if there are any sore or bleeding areas of skin around your back passage.
  • If you have any kind of infection, or if you have ever had tuberculosis (TB).
  • If you have had a heart attack, or if you have a heart condition.
  • If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
  • If you have sugar diabetes, or if you have an eye condition called glaucoma. You should also tell your doctor if a close member of your family has either of these conditions.
  • If you currently have any of the following conditions: high blood pressure, 'thinning' of the bones (osteoporosis), diverticulitis, an underactive thyroid, epilepsy, cataracts, or a condition causing severe muscle weakness, called myasthenia gravis.
  • If you have ever had any of the following: a blood clot in a blood vessel, a stomach ulcer, or a mental health problem such as depression or psychosis.
  • If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine, or if you have ever developed muscle pain after taking a steroid medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about hydrocortisone, and will also provide you with a full list of the side-effects which you could experience from using it. It will also give you a step-by-step guide on how to use it.
  • Your doctor will tell you how often to use hydrocortisone foam. It is usual to administer it once or twice a day for 2-3 weeks, and then for the dose to be reduced to once daily or on alternate days for a short while. This information will be on the label of the pack to remind you.

How to use Colifoam®

  1. Shake the canister well before each use.
  2. Withdraw the plunger on the applicator until it stops at the catch line.
  3. Hold the applicator with the nozzle downwards, and then insert the top of the canister of foam into the nozzle.
  4. Press the canister top gently so that foam fills about a quarter of the applicator. Only a short press is needed to do this. Wait a few seconds for the foam to expand and then press the canister top again. Continue to fill the applicator a little at a time until the foam reaches the 'fill' line.
  5. Stand with one leg raised on a chair (or lie down on your side if you prefer) and gently insert the applicator into your back passage. Push the plunger to empty the applicator.
  6. Take the applicator apart and wash it after each use.
  • Try to keep your regular appointments with your doctor and clinic. This is so your doctor can check on your progress.
  • Continue to use the foam for as long as your doctor has told you to. A course of treatment is likely to last a few weeks.
  • If you forget a dose, don't worry, just remember to administer the next dose when it is due.
  • Hydrocortisone can suppress your immune system, so it is important if you become ill that you make an appointment to see your doctor straightaway. Also, if you come into contact with anyone who has measles, shingles or chickenpox (or anyone who suspects they might have one of these viruses), you should see your doctor as soon as possible.
  • Some vaccines may not be suitable for you while you are being treated with hydrocortisone. If you need any immunisations, make sure you mention that you are using a steroid medicine.
  • If you are having an operation or any medical treatment, tell the person carrying out the treatment that you are using hydrocortisone.
  • If you buy any medicines, check with a pharmacist that they are safe to take with your prescribed medicines.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with hydrocortisone when used rectally, although these are uncommon. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Rectal hydrocortisone side-effects (these affect less than 1 in 100 people)What can I do if I experience this?
Local irritationThis should soon ease. If it continues, speak with your doctor
Changes in behaviour or moodIf you become anxious, confused, or start having worrying thoughts about harming yourself, speak with your doctor as soon as possible

For more information about the side-effects which are possible when hydrocortisone is used over a long period of time, see the separate condition leaflet called Oral Steroids.

If you experience any other symptoms which you think may be due to hydrocortisone, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never use more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Colifoam®; Meda Pharmaceuticals, The electronic Medicines Compendium. Dated November 2013.
  • British National Formulary; 71st Edition (Mar-Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Adrian Bonsall
Document ID:
125 (v25)
Last Checked:
25/05/2016
Next Review:
25/05/2019
The Information Standard - certified member

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