Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- sangramento retal
- diarreia
- sangue nas fezes
Outros fatores diagnósticos
- dor abdominal
- artrite e espondilite
- desnutrição
- desconforto abdominal
- febre
- perda de peso
- constipação
- erupção cutânea
- uveíte e episclerite
- palidez
Fatores de risco
- história familiar de doença inflamatória intestinal
- antígeno leucocitário humano-B27
- infecção
- uso de anti-inflamatórios não esteroidais (AINEs)
- não fumante ou ex-fumante
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- estudos das fezes para patógenos infecciosos
- calprotectina fecal (CF)
- Hemograma completo
- perfil metabólico completo (incluindo testes da função hepática)
- velocidade de hemossedimentação (VHS)
- proteína C-reativa
- radiografia abdominal simples
- sigmoidoscopia flexível
- colonoscopia
- biópsias
Investigações a serem consideradas
- Tomografia computadorizada (TC)
- ultrassonografia intestinal
Algoritmo de tratamento
colite ulcerativa aguda grave
doença moderada a grave
doença leve
doença em remissão
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
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
Trevor Winter, MD, PhD
Associate Professor of Medicine
Division of Digestive Diseases and Nutrition
University of Kentucky
Lexington
KY
利益声明
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
利益声明
SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.
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: ulcerative colitis in adults. Am J Gastroenterol. 2019 Mar;114(3):384-413. 摘要
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.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
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].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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