Optimal Management of Acute Severe Ulcerative Colitis (ASUC): Challenges and Solutions

Tom Holvoet,1,2 Triana Lobaton,2 Pieter Hindryckx2 1Department of Gastroenterology, AZ Nikolaas, Sint-Niklaas, Belgium; 2Department of Gastroenterology, University Hospital Ghent, Ghent, BelgiumCorrespondence: Tom Holvoet Email tom.holvoet@aznikolaas.beAbstract: Acute severe colitis is a severe complication of ulcerative colitis, affecting approximately 20% of patients. For physicians, it remains a challenging condition to treat. Current treatment algorithms have diminished the mortality associated with acute severe ulcerative colitis (ASUC), but colectomy rates remain high (approximately 30%) despite advances in therapy. Colectomy in ASUC is particularly associated with important postoperative complications and morbidity. In this review, reasons for the inability to improve care and avoid evolution to colectomy for ASUC are explored and solutions that might lead to a better management of the disease are investigated.Keywords: acute severe colitis, ulcerative colitis, inflammatory bowel disease