Clinical Case Database / Category: Patient Management

Acute severe ulcerative colitis

Publication details

Simon TC Peake MBBS, BSc, MRCP, Jonathan Landy MBCHB, BMedSci, MRCP, Ailsa L Hart BMBCh MRCP PhD
Foundation Years Journal, volume 5, issue 8, p.31 (123Doc Education, London, September 2011)


Acute severe ulcerative colitis will affect 15% of UC patients at some point in their disease course.1 Twenty percent of first attacks of UC are 'acute severe' in nature (1). The goal of medical therapy is to avoid colectomy, while preventing complications of disease, side effects of medications and mortality. In addition to medical therapies, optimisation of the overall supportive care of patients with acute severe UC is essential. In this article we present a typical case of acute severe UC presenting on a general medical take. The case has been used to illustrate the diagnosis, investigations and immediate management of a patient with acute severe UC.

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Simon TC Peake MBBS, BSc, MRCP

Inflammatory Bowel Disease Clinical Fellow
St Mark's Hospital

Jonathan Landy MBCHB, BMedSci, MRCP

Inflammatory Bowel Disease Research Fellow
St Mark's Hospital

Ailsa L Hart BMBCh MRCP PhD

Consultant Gastroenterologist and Lead of IBD Unit
St Mark's Hospital and Senior Clinical Lecturer
Imperial College London


1. Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Gut 1963; 4:299-315.
2. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; preliminary report on a therapeutic trial. Br Med J 1954; 2:375-378.
3. Travis SP, Farrant JM, Ricketts C, et al. Predicting outcome in severe ulcerative colitis. Gut 1996; 38:905-910.
4. Laharie D, Bourreille A, Branche J, et al. Cyclosporin versus Infliximab in severe acute ulcerative colitis refractory to intravenous steroids: A randomised study. JCC 2011; 5(1):58.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.