Ulcerative colitis: A rational approach to management

M. F. Picco

Research output: Contribution to journalArticle

Abstract

Ulcerative colitis can manifest as proctitis or proctosigmoiditis, left-sided colitis, or pancolitis. Frequent low-volume bowel movements, urgency, rectal bleeding, and tenesmus alone suggest proctitis. Prostration, fever, tachycardia, dehydration, and complications of blood loss - which may or may not be accompanied by symptoms of proctitis - suggest more severe disease or more extensive bowel involvement. For patients with mild to moderate disease, mesalamine is recommended to induce and maintain remission. Systemic corticosteroids can induce remission in patients with moderate to severe disease but are not useful for maintenance therapy. If severe colitis does not respond to corticosteroids, consider immunosuppressive therapy or colectomy. Other indications for surgery include development of acute complications related to disease activity and chronic complications, such as dysplasia, carcinoma, recurrent hemorrhage, or growth retardation in children.

Original languageEnglish (US)
Pages (from-to)541-548
Number of pages8
JournalConsultant
Volume41
Issue number4
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Medicine(all)

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