Fulminant ulcerative colitis

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Opinion statement

  • Fulminant ulcerative colitis necessitates immediate hospitalization.

  • Supportive therapy such as aggressive rehydration, restriction of oral intake, and consideration of parenteral nutrition should be initiated.

  • High-dose intravenous steroids should be started in almost all cases.

  • Antibiotics and cyclosporine should be considered, especially in disease refractory to steroid therapy.

  • Indications for surgery should always be kept in mind, and early involvement of the surgical team is always encouraged.

  • Avoidance of life-threatening complications such as toxic megacolon, hemorrhage, and perforation is the goal of any treatment for fulminant ulcerative colitis.