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Acute severe ulcerative colitis — RCPSC IM MCQ

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HardGastroenterology/HepatologyAcute severe ulcerative colitisRCPSC IM

A 42-year-old woman with known ulcerative colitis has 10 bloody stools daily, fever and tachycardia. Hemoglobin is 92 g/L, CRP is 118 mg/L and albumin is 25 g/L. Abdominal radiograph shows colonic diameter 4.5 cm without perforation. Stool C difficile testing is negative. What is the most appropriate next step?

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Correct answer: E — Admit for intravenous corticosteroids, venous thromboprophylaxis and early surgical-gastroenterology review

Acute severe ulcerative colitis requires admission, IV corticosteroids, thromboprophylaxis, infection exclusion and early planning for rescue therapy or surgery if non-response.

Reference: Canadian Association of Gastroenterology inflammatory bowel disease guidance