Ulcerative Colitis Clinical Case Review

Eugenia Uche-Anya, MD, MPH, gastroenterology fellow at Massachusetts General Hospital, goes over the treatment options for mild UC:

"So in brief, this is a 62 year old man with newly diagnosed mild ulcerative colitis. He had mild gastrointestinal symptoms without systemic manifestations or severe endoscopic disease, such as deep ulcerations. His disease extent is limited to the rectal sigmoid colon.

The treatment goal for this patient is to achieve clinical remission. That is, resolution of symptoms with the medication that is well tolerated by the patient and acceptable to the patient with as minimal adverse effects as possible. Endoscopic remission with mucosal healing is also key, particularly in reducing the risk of dysplasia and colorectal cancer.

There are a variety of possible treatment options for this patient including five aminosalicylic acid derivatives, that is, mesalamine, which can be taken orally or topically, that is per rectum. Rectal glucocorticoids, budesonide and oral steroids. Typically, topical medications are preferred in patients with limited distal disease, while oral is preferred in patients with more extensive disease."