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| Topic: |
Digestive Diseases (DD) |
| Title: |
Ulcerative Colitis: A Rational Approach to Management. |
| Author: |
Picco, M.F. |
| Source: |
Consultant. 41(4): 541-548. April 1, 2001. |
| Availability: |
Available from Cliggott Publishing Company. 330 Boston Post Road, Darien, CT 06820-4027. (203) 661-0600. |
| Abstract: |
Ulcerative colitis (UC), a type of inflammatory bowel disease can manifest as proctitis or proctosigmoiditis, left sided colitoss, or pancolitis. This article offers a rational approach to the management of patients with UC. Frequent low volume bowel movements, urgency, rectal bleeding, and tenesmus (ineffective spasms of the rectum) alone suggest proctitis. Prostration, fever, tachycardia (racing heartbeat), dehydration, and complications of blood loss (which may or may not be accompanied by symptoms of proctitis) suggest more severe disease or more extensive bowel involvement. For patients with mild to moderate disease, mesalamine is recommended to induce and maintain remission. Systemic corticosteroids can induce remission in patients with moderate to severe disease but are not useful for maintenance therapy. Azathioprine or 6 mercaptopurine can be used to wean patients with moderate to severe colitis from corticosteroids and to maintain remission. If severe colitis does not respond to corticosteroids, immunosuppressive therapy or colectomy may be needed. Other indications for surgery include development of acute complications related to disease activity and chronic complications, such as dysplasia, carcinoma, recurrent hemorrhage, or growth retardation in children. Annual surveillance colonoscopy with biopsy is recommended for patients with pancolitis and left sided colitis. |
| Format: |
Journal Article |
| Language: |
English. |
| Major Keywords: |
Digestive System Diseases. Ulcerative Colitis. Patient Care Management. Classification. Drug Therapy. Surgery. Patient Selection. |
| Minor Keywords: |
Drug Effects. Surgical Techniques. Mesalazine. Aminosalicylates. Immunosuppressive Agents. Colectomy. Complications. Diagnosis. Symptoms. |
| Publication Number: |
DDJA08265 |
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