The Asia-Pacific consensus on ulcerative colitis.
Inflammatory bowel disease (IBD) is increasing in many parts of the Asia-Pacific region. There is a need to improve the awareness of IBD and develop diagnostic and management recommendations relevant to the region. This evidence-based consensus focuses on the definition, epidemiology and management of ulcerative colitis (UC) in Asia. A multi-disciplinary group developed the consensus statements, reviewed the relevant literature, and voted on them anonymously using the Delphi method. The finalized statements were reviewed to determine the level of consensus, evidence quality and strength of recommendation. Infectious colitis must be excluded prior to diagnosing UC. Typical histology and macroscopic extent of the disease seen in the West is found in the Asia-Pacific region. Ulcerative colitis is increasing in many parts of Asia with gender distribution and age of diagnosis similar to the West. Extra-intestinal manifestations including primary sclerosing cholangitis are rarer than in the West. Clinical stratification of disease severity guides management. In Japan, leukocytapheresis is a treatment option. Access to biologic agents remains limited due to high cost and concern over opportunistic infections. The high endemic rates of hepatitis B virus infection require stringent screening before initiating immune-suppressive agents. Vaccination and prophylactic therapies should be initiated on a case-by-case basis and in accordance with local practice. Colorectal cancer complicates chronic colitis. A recent increase in UC is reported in the Asia-Pacific region. These consensus statements aim to improve the recognition of UC and assist clinicians in its management with particular relevance to the region.
Ooi
Choon Jin
CJ
Department of Gastroenterology and Hepatology, Duke-NUS Graduate Medical School and Singapore General Hospital, Singapore. ooi.choon.jin@sgh.com.sg
Fock
Kwong Ming
KM
Makharia
Govind K
GK
Goh
Khean Lee
KL
Ling
Khoon Lin
KL
Hilmi
Ida
I
Lim
Wee Chian
WC
Kelvin
Thia
T
Gibson
Peter R
PR
Gearry
Richard B
RB
Ouyang
Qin
Q
Sollano
Jose
J
Manatsathit
Sathaporn
S
Rerknimitr
Rungsun
R
Wei
Shu-Chen
SC
Leung
Wai Keung
WK
de Silva
H Janaka
HJ
Leong
Rupert Wl
RW
D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000209:etiology; D003226:Congresses as Topic; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007937:Leukapheresis / Q000379:methods; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology
D007166:Immunosuppressive Agents