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Cited by 1,548Inflammatory Bowel DiseaseOcular Diseases and Behçet’s SyndromeMicroscopic Colitis

The DOI matches its Crossref record; 483 of the 495 references it cites were found in a registry or an index.

Second European evidence-based consensus on the diagnosis and management of ulcerative colitis Part 2: Current management

Dignass, Axel, Lindsay, James O., Sturm, Andreas, Windsor, Alastair, Colombel, Jean-Frederic, Allez, Mathieu, D'Haens, Gert, D'Hoore, André, Mantzaris, Gerassimos, Novacek, Gottfried, Öresland, Tom, Reinisch, Walter, Sans, Miquel, Stange, Eduard, Vermeire, Severine, Travis, Simon, Van Assche, Gert·2012·Journal of Crohn's and Colitis
DOI 10.1016/j.crohns.2012.09.002
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Abstract

### 5.1 General When deciding the appropriate treatment strategy for active ulcerative colitis one should consider the activity, distribution (proctitis, left-sided, extensive1), and pattern of disease. The disease pattern includes relapse frequency, course of disease, response to previous medications, side-effect profile of medication and extra-intestinal manifestations. The age at onset and disease duration may also be important factors. #### 5.1.1 Disease activity The principal disease activity scoring systems used in clinical trials are covered in Section 1.2 and have been comprehensively reviewed.2 However there are some practical points that are relevant for routine clinical use. For example, it is most important to distinguish patients with severe ulcerative colitis necessitating hospital admission from those with mild or moderately active disease who can generally be managed as outpatients. The simplest, best validated and most widely used index for identifying severe UC remains that of Truelove and Witts3: any patient who has a bloody stool frequency ≥ 6/day and a tachycardia (> 90 bpm), or temperature > 37.8 °C, or anaemia (haemoglobin 30 mm/h) has severe ulcerative colitis (Table 1.3). Only one additional criterion in addition to the bloody stool frequency ≥ 6/day is needed to define a severe attack.4,5 It should be standard practice to confirm the presence of active colitis by sigmoidoscopy before starting treatment. Flexible sigmoidoscopy and biopsy may exclude unexpected causes of symptoms that mimic active disease such as cytomegalovirus colitis, rectal mucosal prolapse, Crohn's disease, malignancy, or even irritable bowel syndrome and haemorrhoidal bleeding. There may be a significant overlap between other diseases that mimic ulcerative colitis and the broad spectrum of UC damage.6,7 In addition, all patients with active disease require stool cultures with Clostridium difficile toxin assay to exclude enteric infection. Patients with an appropriate …

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  1. Ferrante, 2009, Corticosteroids but not infliximab increase short-term postoperative infectious complications in patients with ulcerative colitis, Inflamm Bowel Dis, 15, 1062, 10.1002/ibd.20863 · DOI
  2. Bojic, 2005, Pattern and outcome of severe ulcerative colitis: 15 year data, Gut, 54, A155
  3. Hanauer, 2007, AGA Institute Consensus development conference on the use of biologics in the treatment of inflammatory bowel disease, Gastroenterology, 133, 312
  4. Miner, 1994, The effect of varying dose intervals of mesalamine enemas for the prevention of relapse in distal ulcerative colitis. Gastroenterology 1994;106: A736, Gastroenterology, 106, A736
  5. Sandborn, 2009, Colectomy rate comparison after treatment of ulcerative colitis with placebo or infliximab, Gastroenterology, 137, 1250, 10.1053/j.gastro.2009.06.061 · DOI
  6. Manosa, 2009, Infliximab rescue therapy after cyclosporin failure in steroid-refractory ulcerative colitis, Digestion, 80, 30, 10.1159/000212075 · DOI

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Metadata

Authors
Dignass, A., Lindsay, J. O., Sturm, A., Windsor, A., Colombel, J.-F., Allez, M., D'Haens, G., D'Hoore, A., Mantzaris, G., Novacek, G., Öresland, T., Reinisch, W., Sans, M., Stange, E., Vermeire, S., Travis, S., & Van Assche, G.
Affiliations
Agaplesion Markus Hospital (DE)
ORCID
Venue
Journal of Crohn's and Colitis
Publisher
Oxford University Press (OUP)
Published
2012-12-01
Volume
6
Issue
10
Pages
991-1030
ISSN
  • 1873-9946 (ISSN-L)
  • 1876-4479
DOI
10.1016/j.crohns.2012.09.002
OpenAlex
W2120522488
Cited by
1,548
References
495
Citations by year
2026: 11 · 2025: 25 · 2024: 53 · 2023: 76 · 2022: 115 · 2021: 152 · 2020: 168 · 2019: 161 · 2018: 156 · 2017: 146 · 2016: 165 · 2015: 136 · 2014: 121 · 2013: 57 · 2012: 4
FWCI
60.30
Type
journal article
Language
en
Update notices
expression_of_concern (2022-01-24)
Open access
closed
Locations
  • Journal of Crohn s and Colitis (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
  • Health Sciences › Medicine › Gastroenterology › Microscopic Colitis
Keywords
ulcerative colitis, disease activity assessment
MeSH terms
Adrenal Cortex Hormones, Anti-Inflammatory Agents, Non-Steroidal, Colitis, Ulcerative, Humans, Immunosuppressive Agents, Tumor Necrosis Factor-alpha, Proctocolectomy, Restorative, Maintenance Chemotherapy

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