Management of Acute Severe Ulcerative Colitis
10.3969/j.issn.1008-7125.2019.06.001
- Author:
Ailing LIU
1
Author Information
1. Department of Gastro-enterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
- Publication Type:Journal Article
- Keywords:
Acute Severe Ulcerative Colitis;
Ciclosporin;
Diagnosis;
Infliximab;
Salvage Therapy
- From:
Chinese Journal of Gastroenterology
2019;24(6):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Acute severe ulcerative colitis (ASUC) is a medical emergency that requires prompt diagnosis and treatment. Intravenous corticosteroids are the first-line medical therapy, yet over 30% of the patients are steroid-refractory. The response to steroids should be assessed on day 3 after treatment initiation; in non-responders, treatment options including ciclosporin and infliximab, or surgery should be considered. Both ciclosporin and infliximab are effective and safe salvage therapy. Colectomy is recommended if there is no improvement following 4 to 7 days of salvage therapy. Total proctocolectomy and ileal pouch-anal anastomosis is the standard surgical procedure. A three-step approach is advocated and the postoperative complications should be cared. The diagnosis and treatment of ASUC requires multidisciplinary cooperation in order to improve prognosis and reduce mortality.
