Moderate to Severe Ulcerative Colitis
Key Points
Key Points
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease with peak onset in early adulthood.
- Untreated, the natural history of the disease is one of relapsing and remitting mucosal inflammation.
- Based on population-based cohort studies, the majority of patients with UC have a mild to moderate course, generally most active at diagnosis and then in varying periods of remission or mild activity.
- Approximately 15% patients may experience an aggressive course, and 20% of these patients may require hospitalization for severe disease activity.
- The 5- and 10-year cumulative risk of colectomy is 10–15%, primarily limited to patients with moderate to severe disease activity.
- A subset of hospitalized patients with acute severe ulcerative colitis (ASUC) have short-term colectomy rates of 25–30%.
- Predictors of an aggressive disease course and colectomy are: age <40 at diagnosis, extensive disease, large and/or deep ulcers at endoscopy, presence of extra-intestinal manifestations, early need for corticosteroids and elevated inflammatory markers.
Diagnosis
Diagnos...
...e Severity Scoring SystemsHaving tro...
Treatment
...atment...
...adult outpatients with moderate-seve...
...ients with moderate-severe ulcerative colitis...
...utpatients with moderate-severe ulcera...
...ents with moderate-severe ulcerative...
...n adult outpatients with active moderate-s...
...adult outpatients with moderate-severe...
...utpatients with active moderate-severe ulcera...
...n adult outpatients with moderate-se...
...atients with moderate-severe ulcera...
...ients with moderate-severe ulcerative co...
...t outpatients with moderate-severe ulcerative coli...
...t outpatients with moderate-severe ulcerative col...
...talized adult patients with acute severe ulcerat...
...ed adult patients with acute severe ulcerativ...
...spitalized adult patients with acute s...
...ospitalized adult patients with acute s...
...ure 1. Pharmacological Management o...
...re 2. Pharmacological Management of Ad...