TREATMENT

TREATMENT

E ff ective treatment of UC requires a multidisciplinary approach to management. Members of the IBD multidisciplinary team - typically include specialists in IBD gastroenterology , colorectal surgery , IBD nursing, stoma therapy , gastrointestinal and interventional radiology , pathology , dieticians and nutritional - support services, clinical psychologist and other specialties according to the individual patient’s need. ); Summary box 75.1 Principles of management of ulcerative colitis /uni25CF /uni25CF /uni25CF /uni25CF

Most patients are maintained on optimised medical therapy Acute severe colitis (ASC) requires multidisciplinary management Toxic dilatation or impending complication should be suspected if the patient /uni00A0 develops abdominal tenderness or distension, or deteriorates clinically Patients with colitis are at increased risk of developing cancer; those with pancolitis of long duration are most at risk Sub- Global Sub- Sub- Disease activity score assessment score score on /f_l exible sigmoidoscopy 0 Normal 0 Normal 0 1 Mild 1 Mild 1 2 Moderate 2 Moderate 2 3 Severe 3 Severe 3

Figure 75.5 Computed tomography scan demonstrating colitis with a thickened colonic wall and in /f_l ammatory stranding in the mesentery (courtesy of Dr D Kasir, Hope Hospital, Salford, UK).