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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...

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Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
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Published on: January 5, 2017

Severe acute ulcerative colitis: the pediatric perspective.

Dan Turner1

  • 1Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem 91031, Israel. turnerjd2001@yahoo.com

Digestive Diseases (Basel, Switzerland)
|September 30, 2009
PubMed
Summary
This summary is machine-generated.

Pediatric ulcerative colitis (UC) often presents as extensive disease, with many children requiring advanced therapies beyond corticosteroids. The Pediatric UC Activity Index (PUCAI) aids in early identification of severe cases and treatment escalation needs.

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Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Clinical Pediatrics

Background:

  • Childhood-onset ulcerative colitis (UC) exhibits a higher rate of extensive disease compared to adults.
  • A significant proportion of pediatric UC patients (30-40%) do not respond to corticosteroids.
  • Severe UC admissions in children reach 28% by age 16, necessitating timely intervention.

Purpose of the Study:

  • To evaluate the utility of the Pediatric UC Activity Index (PUCAI) in assessing disease severity and guiding treatment decisions in pediatric ulcerative colitis.
  • To identify predictive markers for corticosteroid failure and the need for second-line therapies or colectomy in children with UC.

Main Methods:

  • Utilized the Pediatric UC Activity Index (PUCAI) to quantify disease severity in pediatric ulcerative colitis patients.
  • Assessed PUCAI scores at specific time points (day 3 and day 5) to predict treatment response and outcomes.
  • Reviewed data on the efficacy and duration of second-line therapies including cyclosporine, tacrolimus, and infliximab.

Main Results:

  • A PUCAI score >65 indicates severe disease, guiding decisions on second-line therapy or colectomy.
  • PUCAI scores >45 on day 3 predict corticosteroid failure (90-95% NPV), while scores >70 on day 5 predict short-term escalation needs (95-100% PPV).
  • Short-term response rates for cyclosporine, tacrolimus, and infliximab range from 60-80%, with infliximab offering prolonged use.

Conclusions:

  • The PUCAI is a valuable tool for early identification of severe pediatric ulcerative colitis and predicting treatment response.
  • Second-line therapies like infliximab are effective, but calcineurin inhibitors require careful bridging to thiopurines.
  • Colectomy indications include toxic megacolon or refractory disease, with careful consideration of quality of life and developmental impact.