Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 24 July 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Strategies for the management of chronic unremitting ulcerative colitis

This month's Alimentary Pharmacology & Therapeutics investigates strategies for the management of chronic unremitting ulcerative colitis.

News image

Chronic active ulcerative colitis is associated with significant morbidity, loss of productivity, increased colorectal cancer risk and cost.

Up to 18% of patients suffer chronic active disease, with 30% requiring colectomy at 10 years.

Dr Mehta and colleagues from the United Kingdom reported that the management remains challenging given the relatively few clinical trials in this area.

The researchers summarized the evidence regarding optimal management strategies for patients with chronic active ulcerative colitis of differing disease extents and degrees of treatment refractoriness.

The team searched the literature using the PubMed and Medline databases.

No time limit was set on article publication for inclusion.

Infliximab and topical tacrolimus are options in refractory proctitis
Alimentary Pharmacology & Therapeutics

The team of doctors reported that the principles of management should focus on confirming disease activity, exclusion of alternative diagnoses, adherence and treatment escalation.

Infliximab and topical tacrolimus are options in refractory proctitis, although the evidence for these therapies is limited.

The doctors examined that both infliximab and adalimumab are effective in corticosteroid-refractory disease, although the proportions of patients achieving corticosteroid-free remission remain modest.

Alternatives include ciclosporin and tacrolimus, and possibly methotrexate.

Colectomy often leads to an improved quality of life, and medical strategies unlikely to provide durable corticosteroid-free remission should not be pursued.

Dr Metha's team commented, "No current pharmacological treatment delivers mucosal healing in the majority of patients."

"Newer treatments such as vedolizumab and tofacitinib may represent valuable future therapies."

"Available medical options should be discussed with patients at every step of their management, with an honest appraisal of the evidence."

"Surgery should always be considered in patients with chronic refractory disease of any extent."

Aliment Pharmacol & Ther 2013:38(2): 77-97
02 July 2013

Go to top of page Email this page Email this page to a colleague

 22 July 2016 
Fecal calprotectin and IBD
 22 July 2016 
Duodenal villous atrophy and celiac disease
 22 July 2016 
Upper GI lesions at primary diagnosis in IBD
 21 July 2016 
Radiofrequency ablation in Barrett's
 21 July 2016 
HCV eradication and inflammation in cirrhotic patients
 21 July 2016 
Surveillance of Barrett's
 20 July 2016 
Nonselective β-blockers and survival in cirrhosis
 20 July 2016 
Adolescent body mass index and and colorectal cancer risk
 20 July 2016 
Genetic biomarkers and IBD treatment response
 19 July 2016 
Prevention of chemotherapy-induced nausea and vomiting
 19 July 2016 
Longterm clinical follow-up of living liver donors
 19 July 2016 
Screening diabetic patients for NAFLD
 18 July 2016 
Rectal neuroendocrine tumors
 18 July 2016 
Liver stiffness measurement in chronic liver disease
 18 July 2016 
Liver cancer prediction scores in Hep B
 15 July 2016 
Patient reported outcomes in celiac disease
 15 July 2016 
Tonsillectomy and IBD risk
 15 July 2016 
Trainee IBD education in the USA
 14 July 2016 
Screening for familial pancreatic cancer
 14 July 2016 
Fecal calprotection for IBD prognosis
 14 July 2016 
Perianal surgery risk in Crohn's
 13 July 2016 
Lung transplant outcomes in Hep C
 13 July 2016 
Psychological comorbidity and postinfectious IBS
 13 July 2016 
Graft selection strategy in living donor liver transplants
 12 July 2016 
Treatment of pediatric acute liver failure
 12 July 2016 
Therapy for iron deficiency anemia in IBD
 12 July 2016 
Surveillance endoscopy in Barrett's esophagus
 11 July 2016 
Disturbed sleep and IBS
 11 July 2016 
Transition to adulthood in celiac disease
 11 July 2016 
Factors that influence access to liver transplant
 08 July 2016 
Mortality and peptic ulcers
 08 July 2016 
Statins and cirrhosis in Hep B
 08 July 2016 
Genetic risk score and body mass index
 07 July 2016 
Predicting food triggers in eosinophilic esophagitis
 07 July 2016 
Extraperitoneal vs transperitoneal colostomy for hernia
 07 July 2016 
Predictors fecal transplant failure in C. diff infection
 06 July 2016 
Therapies for Hep B cure
 06 July 2016 
Hospital volume and liver cancer survival
 06 July 2016 
Adverse events after outpatient colonoscopy
 05 July 2016 
Colorectal surgery and dialysis
 05 July 2016 
Non-invasive scoring systems for fibrosis in NAFLD
 05 July 2016 
Exercise and gastroesophageal reflux
 04 July 2016 
Guidelines on PPI and NSAID prescription
 04 July 2016 
Rectal cancer surgery checklist
 04 July 2016 
Autoimmunity in eosinophilic esophagitis and families
 01 July 2016 
Outcome measures in celiac disease
 01 July 2016 
Growth factor activity and IBD
 01 July 2016 
Aspirin and colorectal cancer
 30 June 2016 
Staging system for familial adenomatous polyposis
 30 June 2016 
Antibiotics in children and obesity
 30 June 2016 
IBS-type symptoms in pediatric IBD
 29 June 2016 
Hep C eradication in people who inject drugs
 29 June 2016 
Anti-tumor necrosis factor in mothers and newborns
 29 June 2016 
Progression to esophageal carcinoma in Barrett's
 28 June 2016 
Gastric cancer screening in the USA
 28 June 2016 
Cancer recurrence after immune-suppressive therapies
 28 June 2016 
Acute severe ulcerative colitis
 27 June 2016 
Tobacco smoking and ulcerative colitis
 27 June 2016 
Epidemiology of NAFLD
 27 June 2016 
The Toronto Consensus for H. pylori treatment

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us