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Ulcerative colitis flare — GPhC CRA MCQ

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HardGI TherapeuticsUlcerative colitis flareGPhC CRA

A 31-year-old man with ulcerative colitis asks for advice about worsening bloody diarrhoea, cramping and urgency for 5 days. He is taking oral mesalazine and has opened his bowels eight times today. He feels light-headed and his pulse is 108bpm. What is the most appropriate action?

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Correct answer: D — refer for urgent same-day medical assessment

Frequent bloody diarrhoea with tachycardia and light-headedness suggests a significant ulcerative colitis flare and possible dehydration. Same-day medical assessment is required to assess severity and consider blood tests, stool tests and corticosteroid treatment. Loperamide is inappropriate in suspected severe colitis because of safety concerns. NSAIDs may worsen gastrointestinal disease and are not suitable here.

Reference: BNF; NICE CKS: Ulcerative colitis