Moderate to Severe Ulcerative Colitis
Key Points
Key Points
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease with peak onset in early adulthood.
- Untreated, the natural history of the disease is one of relapsing and remitting mucosal inflammation.
- Based on population-based cohort studies, the majority of patients with UC have a mild to moderate course, generally most active at diagnosis and then in varying periods of remission or mild activity.
- Approximately 15% patients may experience an aggressive course, and 20% of these patients may require hospitalization for severe disease activity.
- The 5- and 10-year cumulative risk of colectomy is 10–15%, primarily limited to patients with moderate to severe disease activity.
- A subset of hospitalized patients with acute severe ulcerative colitis (ASUC) have short-term colectomy rates of 25–30%.
- Predictors of an aggressive disease course and colectomy are: age <40 at diagnosis, extensive disease, large and/or deep ulcers at endoscopy, presence of extra-intestinal manifestations, early need for corticosteroids and elevated inflammatory markers.
Diagnosis
...iagnosis
...isease Severity Scoring SystemsHav...
Treatment
Treatme...
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...dult outpatients with moderate-severe u...
In adult outpatients with moderate-severe u...
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...outpatients with active moderate-severe ulc...
...adult outpatients with moderate-severe ulcerative...
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...tpatients with moderate-severe ulcerative colitis,...
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...outpatients with moderate-severe ulcerat...
...spitalized adult patients with acute...
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...d adult patients with acute severe ulcerati...
...italized adult patients with acute severe ulcerat...
...armacological Management of Adult Patients Ho...
.... Pharmacological Management of Adult...