Ulcerative colitis
Summary
定义
病史和体格检查
关键诊断因素
- rectal bleeding
- diarrhea
- blood in stool
其他诊断因素
- abdominal pain
- arthritis and spondylitis
- malnutrition
- abdominal tenderness
- fever
- weight loss
- constipation
- skin rash
- uveitis and episcleritis
- pallor
危险因素
- family history of inflammatory bowel disease
- human leukocyte antigen-B27
- infection
- use of nonsteroidal anti-inflammatory drugs (NSAIDs)
- not smoking or former smoker
诊断性检查
首要检查
- stool studies for infective pathogens
- fecal calprotectin (FC)
- CBC
- comprehensive metabolic panel (including LFTs)
- erythrocyte sedimentation rate (ESR)
- CRP
- plain abdominal radiograph
- flexible sigmoidoscopy
- colonoscopy
- biopsies
Tests to avoid
- serologic antibody testing
需考虑的检查
- CT scan
- intestinal ultrasound
治疗流程
acute severe ulcerative colitis (UC)
moderate-to-severe disease
mild disease
disease in remission
撰稿人
作者
Andrew Poullis, BSc, MBBS, MD, FRCP
Consultant Gastroenterologist
Department of Gastroenterology
St George’s Hospital
London
UK
利益声明
AP is an author of a reference cited in this topic.
Sailish Honap, MBChB (Hons), MRes, MRCP (UK)
Consultant Gastroenterologist
Department of Gastroenterology
St George’s Hospital
London
UK
利益声明
SH has received honoraria from Pfizer (speaker, consultant, advisory board member, and received travel grants), Janssen (speaker fees, travel grants), AbbVie (speaker fees, consultant, travel grants), Takeda (speaker fees), Ferring (travel grants), Pharmacosmos (travel grants), Galapagos (travel grants).
Kamal Patel,
利益声明
all disclosures
Aaron Bhakta, BMedSci (Hons), BMBS, MSc, MRCP
Clinical Fellow in Gastroenterology
Department of Gastroenterology
St George’s Hospital
London
UK
利益声明
AB declares that he has no competing interests.
鸣谢
Dr Hesam A. Nooredinvand, and Dr Andrew Poullis would like to gratefully acknowledge Dr Ben Shandro, Dr Anet Soubieres, Dr Rhys Hewett, Dr Willem J.S. de Villiers, and Dr Houssam Mardini, previous contributors to this topic.
利益声明
BS, AS, RH, WJSD, and HM declare that they have no competing interests.
同行评议者
Stephen B Hanauer, MD
Professor of Medicine
Gastroenterology and Hepatology
Northwestern University
Evanston
IL
利益声明
SW declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
World Gastroenterology Organisation. Global guidelines: inflammatory bowel disease. Aug 2015 [internet publication].全文
Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline update: ulcerative colitis in adults. Am J Gastroenterol. 2025 Jun 3;120(6):1187-224.全文 摘要
Moran GW, Gordon M, Sinopolou V, et al. British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025. Gut. 2025 Jun 23;74(Suppl 2):s1-101.全文 摘要
Singh S, Loftus EV Jr, Limketkai BN, et al. AGA living clinical practice guideline on pharmacological management of moderate-to-severe ulcerative colitis. Gastroenterology. 2024 Dec;167(7):1307-43.全文 摘要
Harbord M, Eliakim R, Bettenworth D, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: current management. J Crohns Colitis. 2017 Jul 1;11(7):769-84.全文 摘要
National Institute for Health and Care Excellence (UK). Ulcerative colitis: management. May 2019 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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