Clinical management of severe active ulcerative colitis in the TNF-a inhibitors era

  • Andrea Calafiore | calafiore.a@gmail.com Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Fernando Rizzello Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Chiara Praticò Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Paolo Gionchetti Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Carlo Calabrese Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Giuseppina Liguori Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
  • Massimo Campieri Department of Clinical Medicine, IBD Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.

Abstract

Ulcerative colitis (UC) is a chronic inflammation of the coli mucosa clinically characterized by bloody diarrhea, abdominal pain and other systemic symptoms. The onset, as well as subsequent relapses, may occur with varying degrees of clinical and endoscopic activity and extent of disease. The clinical and endoscopic activity varies from mild to severe, while the extent of disease, without interruption, may involve from the rectum up to the entire colon. The severe form, when not properly and promptly treated, can be life-threatening and may determine various complications requiring urgent surgical treatment. Early recognition of severe forms, their treatment and patient monitoring can reduce morbidity and mortality, and improve surgical outcome. Since the 1950s, systemic corticosteroids have been the first-line treatment in severe active UC. Today, appropriate patient monitoring, and recognition of clinical, radiological and laboratory findings indicative of steroid failure guide the clinician in the use of immunomodulatory drugs or suggest indications for surgery. The aim of our study is to review the more recent data and guidelines that could be useful in clinical practice for the management of severe UC.

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Published
2013-12-17
Section
Reviews
Keywords:
ulcerative colitis, treatment, infliximab, surgery, management.
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How to Cite
Calafiore, A., Rizzello, F., Praticò, C., Gionchetti, P., Calabrese, C., Liguori, G., & Campieri, M. (2013). Clinical management of severe active ulcerative colitis in the TNF-a inhibitors era. Italian Journal of Medicine, 7(4), 272-277. https://doi.org/10.4081/itjm.2013.272

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