Algorithm for managing severe ulcerative colitis.
Acute severe ulcerative colitis as defined by Truelove Witt's criteria is a medical emergency which requires hospitalization. Patient requires close clinical monitoring with assessment of daily vital parameters, stool frequency, serum electrolytes and daily abdominal examination Intravenous corticosteroids are the mainstay of therapy. Approximately two thirds of patients will respond to steroids. Response to steroids should be assessed at day 3 of admission and partial/non-responders should be considered for alternative medical therapy/surgery. Medical rescue therapies include intravenous cyclosporin and infliximab. This article provides an time bound step up algorithm for management of acute severe ulcerative colitis.
Vineet
V
Ahuja
Ajay
A
Kumar
Rakesh
R
Kochhar
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000628:therapy*; D003376:Counseling; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D004630:Emergencies; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000069285:Infliximab; D007262:Infusions, Intravenous; D008991:Monitoring, Physiologic; D018529:Nutritional Support; D012074:Remission Induction; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000069285:Infliximab; D016559:Tacrolimus