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Review
. 2020 Jul;36(4):265-276.
doi: 10.1097/MOG.0000000000000637.

The management of the hospitalized ulcerative colitis patient: the medical-surgical conundrum

L Campbell Levy  1 , Elliot S Coburn  1 , Sarah Choi  2 , Stefan D Holubar  2
Affiliations
Review

The management of the hospitalized ulcerative colitis patient: the medical-surgical conundrum

L Campbell Levy et al. Curr Opin Gastroenterol. 2020 Jul.

Abstract

Purpose of review: In this review article, we address emerging evidence for the medical and surgical treatment of the hospitalized patient with ulcerative colitis.

Recent findings: Ulcerative colitis is a chronic inflammatory disease involving the colon and rectum. About one-fifth of patients will be hospitalized from ulcerative colitis, and about 20-30%, experiencing an acute flare will undergo colectomy. Because of the significant clinical consequences, patients hospitalized need prompt evaluation for potential complications, stratification of disease severity, and a multidisciplinary team approach to therapy, which involves both the gastroenterologist and surgeon. Although corticosteroids remain first-line therapy, second-line medical rescue options, primarily infliximab or cyclosporine, are considered within 3-5 days of presentation. In conjunction, an early surgical consultation to present the possibility of a staged proctocolectomy as one of the therapeutic options is equally important.

Summary: A coordinated multidisciplinary, individualized approach to treatment, involving the patient preferences throughout the process, is optimal in providing patient-centered effective care.

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References

    1. Dinesen LC, Walsh AJ, Protic MN, et al. The pattern and outcome of acute severe colitis. J Crohns Colitis 2010; 4:431–437.
    1. Dulai PS, Jairath V. Acute severe ulcerative colitis: latest evidence and therapeutic implications. Ther Adv Chronic Dis 2018; 9:65–72.
    1. Travis SP, Farrant JM, Ricketts C, et al. Predicting outcome in severe ulcerative colitis. Gut 1996; 38:905–910.
    1. Lennard-Jones JE, Ritchie JK, Hilder W, Spicer CC. Assessment of severity in colitis: a preliminary study. Gut 1975; 16:579–584. PMID: 1183857.
    1. Chiu YH, Chen JD, Tiu CM, et al. Reappraisal of radiographic signs of pneumoperitoneum at emergency department. Am J Emerg Med 2009; 27:320–327.