Medical Management of Chronic Ulcerative Colitis
In the twenty-first century, the management of inflammatory bowel disease can be considered a subspecialty within gastroenterology and colon and rectal surgery, “IBD-ology.” This is mainly due to the development of complex, expensive medical treatments such as biologic agents and management of patients with ileal pouch-anal anastomosis (IPAA). In this chapter, in Part 1 we introduce CUC and its definition, classifications, and epidemiology. Part 2 will review available medications, while Part 3 will present an algorithmic approach to CUC treatment. This chapter, intended for a surgical audience, aims to be a practical overview with clinical pearls rather than an exhaustive review.
KeywordsUlcerative colitis Crohn’s disease Indeterminate colitis Medical therapy 5-ASA Immunomodulators AZA 6MP Methotrexate Corticosteroids Biologic agents Infliximab Anti-TNF-alpha Anti-integrin Pouchitis Indeterminate pouchitis Ileal pouch-anal anastomosis
“PillCam®” video clip demonstrating the camera within a translucent housing. Note the strobe lighting, which allows mucosal visualization. Courtesy of Dr. Stefan D. Holubar MD, MS. (MP4 4565 kb)