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World J Gastrointest Pathophysiol. Nov 15, 2014; 5(4): 579-588
Published online Nov 15, 2014. doi: 10.4291/wjgp.v5.i4.579
Management of acute severe ulcerative colitis
Saurabh Kedia, Vineet Ahuja, Rakesh Tandon
Saurabh Kedia, Vineet Ahuja, Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029, India
Rakesh Tandon, Department of Gastroenterology, Pushpawati Singhania Research Institute for Liver, New Delhi 110017, India
Author contributions: All authors contributed to this paper.
Correspondence to: Dr. Rakesh Tandon, Head, Department of Gastroenterology, Pushpawati Singhania Research Institute for Liver, Renal and Digestive Diseases, Press Enclave Marg, Sheikh Sarai II, New Delhi 110017, India. drrakeshtandon@hotmail.com
Telephone: +91-11-30611999 Fax: +91-11-29250548
Received: July 5, 2014
Revised: August 15, 2014
Accepted: September 23, 2014
Published online: November 15, 2014
Core Tip

Core tip: The mortality of severe ulcerative colitis has drastically reduced from 30%-60% in pre steroid era to 1%-2.9% at present. However these figures are for specialist centers and at peripheral centers the mortality figures may be higher. The objective of this review is to provide in depth information for what can be categorized as a gastrointestinal medical emergency with the hope that informed clinical practices may translate to superior patient care at tertiary as well as peripheral centers treating ulcerative colitis. This review provides time bound framework, which looks at stepwise management of acute severe ulcerative colitis and explores the recent concepts of choice between biologics and cyclosporin colon rescue therapies in case of steroid refractory disease.