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Acute severe ulcerative colitis: from pathophysiology to clinical management
Pieter Hindryckx1,2,3, Vipul Jairath4,3, Geert D'Haens2,3
1Department of Gastroenterology, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium.
Nature Reviews. Gastroenterology & Hepatology
|September 2, 2016
Summary
Acute severe ulcerative colitis (ASUC) is a serious condition requiring prompt hospitalization and treatment. Management includes corticosteroids, with rescue therapies like ciclosporin or infliximab for non-responders, and surgery if medical treatment fails.
Area of Science:
- Gastroenterology
- Immunology
- Internal Medicine
Background:
- Ulcerative colitis is a chronic inflammatory bowel disease affecting the colon and rectum.
- A dysregulated immune response in genetically susceptible individuals triggers the disease.
- Severe flares necessitate hospitalization and intensive management.
Purpose of the Study:
- To review the pathophysiology of acute severe ulcerative colitis (ASUC).
- To outline modern clinical management strategies for ASUC.
- To provide a comprehensive overview of ASUC from disease onset to treatment outcomes.
Main Methods:
- Review of current medical literature on ASUC.
- Analysis of diagnostic criteria and treatment protocols.
- Synthesis of evidence-based recommendations for ASUC management.
Main Results:
- ASUC is a life-threatening condition requiring immediate medical attention.
- First-line treatment involves intravenous corticosteroids.
- Rescue therapies (ciclosporin, infliximab) and colectomy are options for refractory cases.
Conclusions:
- Early recognition and prompt management are crucial for improving outcomes in ASUC.
- A stepwise approach to treatment, from corticosteroids to rescue therapies or surgery, is essential.
- Ongoing monitoring of clinical and laboratory parameters guides treatment decisions in ASUC.
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