Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- sangramento retal
- diarreia
- sangue nas fezes
Other diagnostic factors
- dor abdominal
- artrite e espondilite
- desnutrição
- desconforto abdominal
- febre
- perda de peso
- constipação
- erupção cutânea
- uveíte e episclerite
- palidez
Risk factors
- história familiar de doença inflamatória intestinal
- antígeno leucocitário humano-B27
- infecção
- uso de anti-inflamatórios não esteroidais (AINEs)
- não fumante ou ex-fumante
Diagnostic investigations
1st investigations to order
- 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
Investigations to consider
- Tomografia computadorizada (TC)
- ultrassonografia intestinal
Treatment algorithm
colite ulcerativa aguda grave
doença moderada a grave
doença leve
doença em remissão
Contributors
Authors
Andrew Poullis, BSc, MBBS, MD, FRCP
Consultant Gastroenterologist
Department of Gastroenterology
St George’s Hospital
London
UK
Disclosures
AP is an author of a reference cited in this topic.
Sailish Honap,
Consultant Gastroenterologist
Department of Gastroenterology
St George’s Hospital
London
UK
Disclosures
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,
Disclosures
all disclosures
Aaron Bhakta, BMedSci (Hons), BMBS, MSc, MRCP
Clinical Fellow in Gastroenterology
Department of Gastroenterology
St George’s Hospital
London
UK
Disclosures
AB declares that he has no competing interests.
Acknowledgements
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.
Disclosures
BS, AS, RH, WJSD, and HM declare that they have no competing interests.
Peer reviewers
Trevor Winter, MD, PhD
Associate Professor of Medicine
Division of Digestive Diseases and Nutrition
University of Kentucky
Lexington
KY
Disclosures
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
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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