Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada

Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients...

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Autores principales:	Hernández-Rocha,Cristian, Ibáñez,Patricio, Molina,María Elena, Klaassen,Julieta, Valenzuela,Andrea, Candia,Roberto, Bellolio,Felipe, Zúñiga,Álvaro, Miguieles,Rodrigo, Miquel,Juan Francisco, Chianale,José, Álvarez-Lobos,Manuel
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Colitis, Ulcerative Colonic Diseases Drug Therapy Inflammatory Bowel Diseases
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000100013
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spelling	oai:scielo:S0034-988720170001000132017-05-15Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizadaHernández-Rocha,CristianIbáñez,PatricioMolina,María ElenaKlaassen,JulietaValenzuela,AndreaCandia,RobertoBellolio,FelipeZúñiga,ÁlvaroMiguieles,RodrigoMiquel,Juan FranciscoChianale,JoséÁlvarez-Lobos,Manuel Colitis, Ulcerative Colonic Diseases Drug Therapy Inflammatory Bowel Diseases Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy. In patients without response, cytomegalovirus infection must be quickly ruled out to escalate to second line therapy with biological drugs or cyclosporine. Total colectomy must not be delayed if there is no response to second line therapy, if there is a contraindication for second line therapies or there are complications such as: megacolon, perforation or massive bleeding. An active management with quick escalation on therapy allows to decrease the prolonged exposure to corticoids, reduce colectomy rates and its perioperative complications.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.1 20172017-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000100013es10.4067/S0034-98872017000100013
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Colitis, Ulcerative Colonic Diseases Drug Therapy Inflammatory Bowel Diseases
spellingShingle	Colitis, Ulcerative Colonic Diseases Drug Therapy Inflammatory Bowel Diseases Hernández-Rocha,Cristian Ibáñez,Patricio Molina,María Elena Klaassen,Julieta Valenzuela,Andrea Candia,Roberto Bellolio,Felipe Zúñiga,Álvaro Miguieles,Rodrigo Miquel,Juan Francisco Chianale,José Álvarez-Lobos,Manuel Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada
description	Ulcerative Colitis (UC) is a chronic inflammatory disease involving the colon, with alternating periods of remission and activity. Exacerbations can be severe and associated with complications and mortality. Diagnosis of severe UC is based on clinical, biochemical and endoscopic variables. Patients with severe UC must be hospitalized. First line therapy is the use of intravenous corticoids which achieve clinical remission in most patients. However, 25% of patients will be refractory to corticoids, situation that should be evaluated at the third day of therapy. In patients without response, cytomegalovirus infection must be quickly ruled out to escalate to second line therapy with biological drugs or cyclosporine. Total colectomy must not be delayed if there is no response to second line therapy, if there is a contraindication for second line therapies or there are complications such as: megacolon, perforation or massive bleeding. An active management with quick escalation on therapy allows to decrease the prolonged exposure to corticoids, reduce colectomy rates and its perioperative complications.
author	Hernández-Rocha,Cristian Ibáñez,Patricio Molina,María Elena Klaassen,Julieta Valenzuela,Andrea Candia,Roberto Bellolio,Felipe Zúñiga,Álvaro Miguieles,Rodrigo Miquel,Juan Francisco Chianale,José Álvarez-Lobos,Manuel
author_facet	Hernández-Rocha,Cristian Ibáñez,Patricio Molina,María Elena Klaassen,Julieta Valenzuela,Andrea Candia,Roberto Bellolio,Felipe Zúñiga,Álvaro Miguieles,Rodrigo Miquel,Juan Francisco Chianale,José Álvarez-Lobos,Manuel
author_sort	Hernández-Rocha,Cristian
title	Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada
title_short	Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada
title_full	Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada
title_fullStr	Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada
title_full_unstemmed	Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada
title_sort	diagnóstico y manejo de colitis ulcerosa grave: una mirada actualizada
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000100013
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Diagnóstico y manejo de colitis ulcerosa grave: Una mirada actualizada

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