Management

There have been massive improvements in the management of ulcerative colitis in the past 40 or 50 years, as evidenced by the death rates in severe attacks:

• before 1952, 45%
• now, 1 to 2 %

The management has been improved by:

• corticosteroids
• better understanding of fluid balance and electrolytes in severely ill patients
• better understanding of indicators of severity of the disease

Note that all the management strategies listed here require considerable modification in children.

Be aware that there may be an increased likelihood of needing surgery for people with any of the following:

• stool frequency more than 8 per day
• pyrexia
• tachycardia
• an abdominal X-ray showing colonic dilatation
• low albumin, low haemoglobin, high platelet count or C-reactive protein (CRP) above 45 mg/litre (bear in mind that normal values may be different in pregnant women)

Reference:

• NICE (May 2019). Ulcerative colitis Management in adults, children and young people