Medical management of severe ulcerative colitis.
The medical management of patients with severe ulcerative colitis requires initial stabilization, careful and repeated evaluations to exclude confounding or coexisting diagnoses, and timely delivery of appropriate medications. Medical therapies for these patients are potent but may be toxic, and administration must be done by experienced medical professionals, with adequate access to appropriate laboratory, radiographic, endoscopic, and surgical facilities. Patients who fail to respond to high-dose intravenous corticosteroids in a timely basis should be evaluated for cyclosporin therapy, or proceed to surgery. The promise of newer, investigational therapies to induce and maintain remission must be borne out by large controlled trials.
Chang
Justin C
JC
Section of Gastroenterology, Department of Medicine, The University of Chicago, 5841 South Maryland Avenue, MC 4076, Chicago, IL 60637, USA.
Cohen
Russell D
RD
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D003663:Decision Trees; D004334:Drug Administration Schedule; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015122:Mercaptopurine / Q000008:administration & dosage / Q000627:therapeutic use; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D015122:Mercaptopurine; D001379:Azathioprine