title: [Management of diagnosis and treatment in ulcerative colitis].
abstract: Ulcerative colitis (UC) is a chronic inflammatory bowel disease limited to the mucosa and affecting the rectum and the colon continuously. Salicylates are the first line treatment for moderate forms. Corticosteroids are used to induce remission, but are not given as maintenance therapy. Thiopurines are indicated as maintenance therapy in case of failure of salicylates or cortico-dependence. Anti TNF alpha are indicated in cortico-resistant severe flares or if cortico- dependence. Vedolizumab (anti-integrin) is the first non anti-TNF alpha biotherapy available for the treatment of UC. Severe acute colitis is a medical emergency; diagnosis is based on Lichtiger score. An emergency colectomy for severe acute colitis is indicated in cases of surgical complication or resistance to medical therapy. UC patients with extension beyond splenic flexure are at risk of colorectal cancer, increasing with the duration of the disease, severity of mucosal inflammation, family history of colorectal cancer, and the existence of sclerosing cholangitis. Annual surveillance colonoscopy is required in patients with sclerosing cholangitis regardless of the extension of their UC.
authors.affiliation: AP-HP, hôpital Cochin, service de gastroentérologie, 75014 Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Klotz
authors.affiliation: AP-HP, hôpital Cochin, service de gastroentérologie, 75014 Paris, France; Université Sorbonne Paris Descartes, faculté de médecine, 75014 Paris, France.
authors.forename: Maximilien
authors.initials: M
authors.lastname: Barret
authors.affiliation: AP-HP, hôpital Cochin, service de gastroentérologie, 75014 Paris, France; Université Sorbonne Paris Descartes, faculté de médecine, 75014 Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Dhooge
authors.affiliation: AP-HP, hôpital Cochin, service de radiologie, 75014 Paris, France.
authors.forename: Ammar
authors.initials: A
authors.lastname: Oudjit
authors.affiliation: AP-HP, hôpital Cochin, service de gastroentérologie, 75014 Paris, France; Université Sorbonne Paris Descartes, faculté de médecine, 75014 Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.affiliation: AP-HP, hôpital Cochin, service de gastroentérologie, 75014 Paris, France; Université Sorbonne Paris Descartes, faculté de médecine, 75014 Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.affiliation: AP-HP, hôpital Cochin, service de gastroentérologie, 75014 Paris, France. Electronic address: vered.abitbol@cch.aphp.fr.
authors.forename: Vered
authors.initials: V
authors.lastname: Abitbol
mesh_terms: D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000209:etiology / Q000517:prevention & control; D003938:Diagnostic Techniques, Digestive System; D006801:Humans; D012074:Remission Induction / Q000379:methods