| [ Summary ] |
With advances in steroid therapies, death from ulcerative colitis (UC) is now rare but morbidity has increased due to delays, in surgical therapy. In the medical management of severe UC we are occasionally presented with severe symptoms, including minor perforations, toxic megacolon and massive bleeding. Treatment in these cases is as follows: 1-1.5mg/kg of steroid is administered. Patients with severe colitis should not receive fluids or food. Intensive monitoring with daily abdominal radiographs, determination of complete blood counts and serum electrolytes should be performed. Support with fluid and electrolytes, blood transfusions, and human albumin should be administered also. Antibiotics should be added to the regimen. Any deterioration or failure to improve within a few days is an indication for colectomy, or other therapies. |