Acute Severe Ulcerative Colitis: Review of Management and Emerging Treatments

Abstract

Acute severe ulcerative colitis (ASUC) is a medical emergency, with an overall mortality rate of 1%. Patients with ulcerative colitis (UC) have a 20–25% rate of severe exacerbation requiring hospitalization for urgent medical treatment and surgical consideration. The rate of re-hospitalization for recurrent ASUC is 34.4%, and it typically occurs within 24 months of the index admission. Treatment requires a patient-centred multidisciplinary approach that includes gastroenterology, colorectal surgery, and nutrition support, with the goal of minimizing disease complications, adverse events of treatment, and healthcare costs.6 Clinicians and patients have an increasing number of treatment options and additional safety issues to consider. We review the current approach to management and summarize emerging data on the use of novel agents to treat ASUC.