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...
...sease Severity Scoring SystemsHaving trou...
Treatment
...atment...
...ients with moderate-severe ulcerative colitis, th...
...outpatients with moderate-severe ul...
...adult outpatients with moderate-severe ulcerative...
...ult outpatients with moderate-severe ulcerative c...
...outpatients with active moderate-severe u...
...outpatients with moderate-severe ulcerati...
...n adult outpatients with active moderate-sev...
...outpatients with moderate-severe ulc...
...patients with moderate-severe ulcerative colit...
...patients with moderate-severe ulcerative colitis,...
...tpatients with moderate-severe ulcerative coliti...
...n adult outpatients with moderate-severe ulcerati...
...d adult patients with acute severe...
...adult patients with acute severe ul...
...adult patients with acute severe ulcerative...
...zed adult patients with acute sever...
...harmacological Management of Adult Patients H...
...armacological Management of Adult Outpatients...