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Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
Published on: May 16, 2025
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Management of acute severe ulcerative colitis
Saurabh Kedia1, Vineet Ahuja1, Rakesh Tandon1
1Saurabh Kedia, Vineet Ahuja, Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029, India.
World Journal of Gastrointestinal Pathophysiology
|November 18, 2014
Summary
Management of severe ulcerative colitis now includes rescue therapies like infliximab and cyclosporin alongside steroids or surgery. Early assessment and timely decisions are crucial for better patient outcomes and reduced mortality.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Internal Medicine
Background:
- Acute severe ulcerative colitis management has evolved beyond steroids or colectomy.
- It remains a medical emergency necessitating hospitalization and multidisciplinary care.
Purpose of the Study:
- To outline the current management strategies for acute severe ulcerative colitis.
- To highlight the role of novel rescue therapies and time-bound decision-making.
Main Methods:
- Review of current therapeutic options for acute severe ulcerative colitis.
- Assessment of response to intravenous corticosteroids at day 3.
- Consideration of medical rescue therapies (cyclosporin, infliximab) or surgery for non-responders.
Main Results:
- Intravenous corticosteroids are the primary therapy.
- Cyclosporin and infliximab show comparable efficacy as rescue therapies (70-75% short-term, 50% long-term response).
- Long-term cyclosporin response improves with concurrent thiopurine initiation.
Conclusions:
- Time-bound decision-making is key to reducing mortality.
- Cyclosporin and infliximab are effective medical rescue options.
- Colectomy is indicated for patients refractory to medical rescue therapies.
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