A 25-year-old woman with ulcerative colitis has 8 bloody stools daily, fever and tachycardia. CRP is 82 mg/L and abdominal radiograph shows no toxic

Question

A 25-year-old woman with ulcerative colitis has 8 bloody stools daily, fever and tachycardia. CRP is 82 mg/L and abdominal radiograph shows no toxic megacolon. Stool cultures and Clostridioides difficile testing have been sent. What is the most appropriate management?

Accepted Answer

Admit for intravenous corticosteroids and close colorectal-gastroenterology review

Answer

Commence azathioprine as induction monotherapy

Answer

Schedule elective colonoscopy in 3 months

Answer

Start loperamide and discharge with oral fluids

Answer

Use oral mesalazine alone and repeat CRP

Acute severe ulcerative colitis — RACP Adult Medicine MCQ

A 25-year-old woman with ulcerative colitis has 8 bloody stools daily, fever and tachycardia. CRP is 82 mg/L and abdominal radiograph shows no toxic megacolon. Stool cultures and Clostridioides difficile testing have been sent. What is the most appropriate management?