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Colitis ulcerosa

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 28 Sep 2025
Última atualização: 29 Jul 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presencia de factores de riesgo
  • sangrado rectal
  • diarrea
  • sangre en las heces
Detalhes completos

Outros fatores diagnósticos

  • dolor abdominal
  • artritis y espondilitis
  • desnutrición
  • abdomen doloroso a la palpación
  • fiebre
  • pérdida de peso
  • estreñimiento
  • erupción cutánea
  • uveítis y epiescleritis
  • palidez
Detalhes completos

Fatores de risco

  • antecedentes familiares de enfermedad inflamatoria intestinal
  • antígeno leucocitario humano-B27
  • infección
  • uso de fármacos antiinflamatorios no esteroideos (AINE)
  • no fumar o ser un exfumador
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • estudios de heces para patógenos infecciosos
  • calprotectina fecal (CF)
  • hemograma completo (HC)
  • perfil metabólico completo (incluidas las pruebas de función hepática [PFH])
  • velocidad de sedimentación globular (VSG)
  • proteína C-reactiva
  • radiografía simple de abdomen
  • sigmoidoscopia flexible
  • colonoscopia
  • biopsias
Detalhes completos

Investigações a serem consideradas

  • exploración por tomografía computarizada (TC)
  • ecografía intestinal
Detalhes completos

Algoritmo de tratamento

AGUDA

colitis ulcerosa aguda grave

enfermedad moderada a grave:

enfermedad leve

CONTÍNUA

enfermedad en remisión

Colaboradores

Autores

Andrew Poullis, BSc, MBBS, MD, FRCP

Consultant Gastroenterologist

Department of Gastroenterology

St George’s Hospital

London

UK

Declarações

AP is an author of a reference cited in this topic.

Sailish Honap,

Consultant Gastroenterologist

Department of Gastroenterology

St George’s Hospital

London

UK

Declarações

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,

Declarações

all disclosures

Aaron Bhakta, BMedSci (Hons), BMBS, MSc, MRCP

Clinical Fellow in Gastroenterology

Department of Gastroenterology

St George’s Hospital

London

UK

Declarações

AB declares that he has no competing interests.

Agradecimentos

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.

Declarações

BS, AS, RH, WJSD, and HM declare that they have no competing interests.

Revisores

Trevor Winter, MD, PhD

Associate Professor of Medicine

Division of Digestive Diseases and Nutrition

University of Kentucky

Lexington

KY

Declarações

TW declares that he has no competing interests.

Sharon Stein, MD

Assistant Professor of Surgery

Division of Colon and Rectal Surgery

University Hospital Case Medical Center

Cleveland

OH

Disclosures

SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

World Gastroenterology Organisation. Global guidelines: inflammatory bowel disease. Aug 2015 [internet publication].Full text

Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019 Mar;114(3):384-413. Abstract

Feuerstein JD, Isaacs KL, Schneider Y, et al. AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis. Gastroenterology. 2020 Apr;158(5):1450-61.Full text  Abstract

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.Full text  Abstract

National Institute for Health and Care Excellence (UK). Ulcerative colitis: management. May 2019 [internet publication].Full text

National Institute for Health and Care Excellence. Colorectal cancer prevention: colonoscopic surveillance in adults with ulcerative colitis, Crohn's disease or adenomas. Sep 2022 [internet publication].Full text

Reference articles

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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    • Management of moderate to severe ulcerative colitis
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  • Patient information

    Colitis ulcerosa: ¿qué tratamientos funcionan?

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