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Ulcerative Colitis Diagnosis and Management: Past, Present, and Future Directions

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Inflammatory Bowel Disease

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Ulcerative colitis (UC) has been identified as a distinct disease entity since the 1800s. Increasing rates, which paralleled industrialization in the west, are now being observed worldwide. While the disease presentation has changed little over time, our ability to diagnose UC has progressed from simple rigid instruments to advanced high-definition video colonoscopes. Advances in diagnostics have been matched by increasing options for medical therapy. The advent of effective therapies, beginning with systemic corticosteroids and sulfasalazine/mesalamine derivatives, lead to an era of nonspecific immunosuppressive therapy and to increasingly targeted biologic and small molecule treatments in the present day. The goal of this review is to provide a comprehensive guide to current evidence-based diagnosis and medical management of UC, from its mildest to most severe presentations, highlighting areas of agreement/standard of care in each section. Additional focused discussion is provided on advances in inflammatory bowel disease (IBD)-colon cancer screening/surveillance, as well as a review of the new “treat to target” paradigm, which is designed to move beyond symptomatic management to deep tissue healing and improved long-term outcomes.

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  1. Northwell Health at North Shore University Hospital and Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA

    Keith Sultan

  2. Northwell Health at Staten Island University Hospital, Department of Medicine, Staten Island, NY, USA

    Noah Becher

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    Ramona Rajapakse

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Sultan, K., Becher, N. (2021). Ulcerative Colitis Diagnosis and Management: Past, Present, and Future Directions. In: Rajapakse, R. (eds) Inflammatory Bowel Disease. Clinical Gastroenterology. Humana, Cham. https://doi.org/10.1007/978-3-030-81780-0_3

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