Abstract
Introduction: Ulcerative colitis (UC) by definition is an inflammation of the mucosa of the colon, it is a subtype of inflammatory bowel diseases (IBD), and it is associated with high morbidities in affected population. During the last two decades, the treatment protocols for ulcerative colitis have changed after the introduction of biological treatment. It is very important to understand the different available biological and conventional agents and the new strategies and techniques used in treatment of UC, including new targets and small-molecule drugs
Aim of work: In this review, we will discuss the most recent evidence regarding the new updates on management of ulcerative colitis.
Methodology: We did a systematic search for the new updates on management of ulcerative colitis in the emergency department using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). We only included full articles.
Conclusions: Achieving remission is an essential therapeutic goal in patients with ulcerative colitis. Persistence of activity, even if mild, causes a reduction in quality of life of the patients. Dose optimization of biologic drugs might go beyond plasma levels, as tissue levels of biologic drugs in the inflamed intestine may not be associated with plasma levels. The value of therapy intensification in patients who are having full clinical remission, but persistent endoscopic lesions, still needs to be determined in ad-hoc designed studies that target to establish the chronic harms and benefits of different therapeutic strategies. The most common errors using available drugs are under-dosing and persisting in therapies that are ineffective. Applying the right doses with strict criteria for drug failure is essential in clinical practice.