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Acute severe ulcerative colitis — RACP Written MCQ

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HardGastroenterology/HepatologyAcute severe ulcerative colitisRACP Written

A 24-year-old man has 10 bloody stools per day, fever and tachycardia. CRP is 94 mg/L and abdominal X-ray shows colonic diameter 5.5 cm. Stool PCR is negative for Clostridioides difficile. What is the most appropriate management?

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Correct answer: A — Intravenous corticosteroids with close monitoring

This is acute severe ulcerative colitis. Intravenous corticosteroids and inpatient monitoring are indicated, with rescue therapy or surgery if response is inadequate.

Reference: Therapeutic Guidelines: Gastrointestinal; Gastroenterological Society of Australia guidance