Relapsing Acute Severe Ulcerative Colitis - Management Algorithm
Loss of Response:
 • (Re)consult Colorectal Surgery
 • Assess Adherence
 • Assess Disease Activity: Flex Sig, FCP, CRP
 • Rule OutC. Diff. & CMV COVID)
 • TDM: IFX/CNl/VDZ Trough
 • If c/f Complication: Cross-Sectional Imaging
 • Urgent surgery: Fulminant UC, Toxic Megacolon, Systemic Toxicity, Patient Preference
Key Points:
 • Consult Colorectal Surgery ASAP with Regular Follow up
 • Surgery ≠ Treatment Failure
 • If Hesitant for Surgery → Multidisciplinary Meeting with Patient and Family
 • RD Referral to Optimize Nutrition
 • CNI + Steroid +IS → PJP Prophylaxis

Algorithm by Dr. Waseem Ahmed @Waseem_AhmedMD

#Relapsing #Ulcerative #Colitis #UC #Management #Algorithm #IBD #Treatment