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[Management of diagnosis and treatment in ulcerative colitis].

[Management of diagnosis and treatment in ulcerative colitis].

Authors :
Klotz C
Barret M
Dhooge M
Oudjit A
Chaussade S
Coriat R
Abitbol V
Source :
Presse medicale (Paris, France : 1983) [Presse Med] 2015 Feb; Vol. 44 (2), pp. 144-9. Date of Electronic Publication: 2014 Dec 19.
Publication Year :
2015

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease limited to the mucosa and affecting the rectum and the colon continuously. Salicylates are the first line treatment for moderate forms. Corticosteroids are used to induce remission, but are not given as maintenance therapy. Thiopurines are indicated as maintenance therapy in case of failure of salicylates or cortico-dependence. Anti TNF alpha are indicated in cortico-resistant severe flares or if cortico- dependence. Vedolizumab (anti-integrin) is the first non anti-TNF alpha biotherapy available for the treatment of UC. Severe acute colitis is a medical emergency; diagnosis is based on Lichtiger score. An emergency colectomy for severe acute colitis is indicated in cases of surgical complication or resistance to medical therapy. UC patients with extension beyond splenic flexure are at risk of colorectal cancer, increasing with the duration of the disease, severity of mucosal inflammation, family history of colorectal cancer, and the existence of sclerosing cholangitis. Annual surveillance colonoscopy is required in patients with sclerosing cholangitis regardless of the extension of their UC.<br /> (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Details

Language :
French
ISSN :
2213-0276
Volume :
44
Issue :
2
Database :
MEDLINE
Journal :
Presse medicale (Paris, France : 1983)
Publication Type :
Academic Journal
Accession number :
25534469
Full Text :
https://doi.org/10.1016/j.lpm.2014.06.025