Ulcerative Colitis : Flare management

Ulcerative colitis (UC) is a common chronic inflammatory disease affecting the colon and rectum. It results from a dysregulated immune response towards intraluminal antigens in individuals who are genetically predisposed. The disease exhibits varying extents and severities, ranging from mild inflammation in the rectum (proctitis) to extensive involvement of the entire colon (pancolitis).

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that typically follows a relapsing-remitting course. It often presents in young adults between the ages of 15 and 30. While the majority of patients exhibit mild to moderate disease, around 10-15% experience severe inflammation at diagnosis. Over their lifetime, approximately 15% of patients will develop an acute severe flare requiring hospitalization. Acute severe UC (ASUC) can lead to significant morbidity and mortality, particularly in younger patients without other comorbidities. Inpatient hospital admission and a multidisciplinary approach are crucial for appropriate and timely management. However, important but simple aspects in the initial work-up and treatment of such patients are frequently overlooked during the acute medical take.

• About 30% of patients with ASUC demonstrate steroid-refractory disease. This is defined by a stool frequency greater than 8 per day, or a stool frequency between 3 to 8 with a C-reactive protein...