title: Further experience in the treatment of severe attacks of ulcerative colitis.
abstract: One hundred courses of an intensive intravenous regimen have been used in 87 patients with severe attacks of ulcerative colitis during the past 5 years, 11 of the patients having been treated more than once during separate admissions to hospital. 60% of the attacks responded swiftly to the regimen, and the patients were symptom-free at the end of the 5-day course. In 15% there was improvement but the patients were not entirely symptom-free. In 25% failure to respond resulted in emergency colectomy, the usual operation being proctocolectomy as a single-stage procedure. There were no deaths directly due to ulcerative colitis or to surgical treatment in these patients during the period of the study, the mean period of follow-up being 25 months; but 4 elderly patients died from unrelated causes. These favourable results are better than most published figures. The advantages of the intensive medical regimen are that: (i) many patients quickly go into clinical remission, which is frequently sustained; and (ii) failure to improve can be regarded as a clear-cut indication for emergency surgery.
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage; D001379:Azathioprine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000628:therapy*; D004630:Emergencies; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011239:Prednisolone / Q000008:administration & dosage; D012007:Rectum / Q000601:surgery; D012075:Remission, Spontaneous; D012460:Sulfasalazine / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D000596:Amino Acids; D005217:Fat Emulsions, Intravenous; D012460:Sulfasalazine; D011239:Prednisolone; D005947:Glucose; D001379:Azathioprine