Role of medical rescue therapy in the management of acute severe ulcerative colitis: the surgical perspective.

摘要

The article by Doherty and Cheifetz in this issue at Expert Review of Gastroenterology and Hepatology is a review designed to advise the clinician on the medical management of the patient presenting with acute severe ulcerative colitis (UC) and, specifically, how to assess the relative roles of various forms of medical 'rescue therapy1 for those who fail the standard institution of high-dose steroids [1]. Approximately 15-25% of UC patients will have a severe flare of their disease requiring hospital admission and approximately a third of these will fail high-dose intravenous steroids. There are really only two medical options for such patients, ciclosporin A or infliximab, although there are relatively less data supporting the latter in such severely ill patients. However, the article is generally an excellent summary from a medical perspective in choosing between these two drugs.