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Acute severe ulcerative colitis — RCPSC IM MCQ

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ModerateGastroenterology/HepatologyAcute severe ulcerative colitisRCPSC IM

A 42-year-old man from Vancouver with extensive ulcerative colitis is admitted with 8 bloody stools daily, fever, tachycardia, CRP 96 mg/L, and colonic wall thickening without perforation. Stool testing for Clostridioides difficile is negative. He received infliximab induction 3 years ago but stopped treatment. What is the most appropriate management?

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Correct answer: B — Intravenous corticosteroids and venous thromboembolism prophylaxis

This is acute severe ulcerative colitis. Initial inpatient treatment is intravenous corticosteroids with VTE prophylaxis, close monitoring, and early rescue planning if there is inadequate response.

Reference: Canadian Association of Gastroenterology IBD guidance