Revolutionizing ulcerative colitis care: The clinical impact of new pharmacologic approaches

The inflammatory bowel disease ulcerative colitis (UC) is defined by recurring inflammation of the intestinal mucosa. The aim of medical therapy is to attain a steroid-free remission as early as possible without causing consequences of the disease and its treatment. The choice of therapy depends on the site, extent, and severity of the disease. Proctitis is treated topically with 5-aminosalicylic acid (5-ASA) preparations. In more extensive or severe disease, corticosteroids and oral and topical 5-ASA agents should be used to induce remission. If this treatment fails, patients have to be hospitalized. Antibodies to tumor necrosis factor-α (infliximab), calcineurin inhibitors (tacrolimus, cyclosporine), intravenous steroids, or immunomodulators (azathioprine, 6-mercaptopurine) are required when the condition is refractory. Perforation, refractory toxic megacolon, and recurrent severe colorectal bleeding all necessitate emergency surgery. Gastroenterologists and surgeons must work closely together to avoid delaying necessary surgical procedures. This paper seeks to provide a broad, practice-based summary of the essential topics in the management of ulcerative colitis. The published consensus guidelines for treating ulcerative colitis are taken from both global and domestic guidelines.