Ulcerative Colitis — UKMLA MCQ

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HardGastroenterologyUlcerative ColitisUKMLA MRCGP AKT MRCP Part 1

A patient has a mild-to-moderate first flare of ulcerative proctosigmoiditis, with no systemic toxicity. Which induction treatment should be offered first?

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Correct answer: E — A topical aminosalicylate

The best answer is “A topical aminosalicylate”. Topical aminosalicylate is the most effective first-line induction treatment for mild-to-moderate proctitis, proctosigmoiditis or left-sided colitis. If response is inadequate, high-dose oral aminosalicylate or a time-limited corticosteroid is added or substituted according to extent and tolerance. Immunomodulators, biologics and surgery are escalation options, not first-line therapy here.

Reference: NICE NG130, Ulcerative colitis: https://www.nice.org.uk/guidance/ng130/chapter/Recommendations