Diagnosis of acute severe colitis

Goenka MK; Nag S; Kumar A; C Ganesh Pai

doi:10.7869/tg.277

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Diagnosis of acute severe colitis

MK Goenka,¹Sourav Nag,¹ Ajay Kumar,² C Ganesh Pai³
Institute of Gastrosciences,¹
Apollo Gleneagles Hospitals,
Kolkata
Gastroenterology and Hepatology²
Indraprastha Apollo Hospital,
New Delhi
Department of Gastroeterology and
Hepatology,³
Kasturba Medical College,
Manipal University,
Manipal, Karnataka, India

Corresponding Author: Dr. MK Goenka
Email: mkgkolkata@gmail.com

Abstract

It is important to assess the severity of ulcerative colitis (UC) in order to decide the intensity of treatment and predict outcome. The criteria instituted by Truelove and Witts almost 60 years back are still being used. However, they lack a scoring system and offer no clear definition for the moderate group. The criteria with scoring system and endoscopic criteria (Mayo Score) seems to be more useful clinically. Endoscopic assessment is very important and a cautious attempt should always be made even if it enables a limited colonoscopic examination. Proctosigmoidoscopy is advocated at initial stages and after 5 to 7 days. The criteria for severity in general are same for pan-colitis and limited disease.