Moderate to Severe Ulcerative Colitis

Publication Date: January 13, 2020

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

Diagnosi...

...isease Severity Scoring SystemsHaving t...


Treatment

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