Review Article

The Practical Management of Acute Severe Ulcerative Colitis

D. Seah; P. De Cruz


Aliment Pharmacol Ther. 2016;43(4):482-513. 

In This Article

Review Criteria and Methodology

The following sources were searched and relevant material was included: (i) PubMed/MEDLINE was searched for all original research studies and systematic reviews published in English-language journals, with a last cut-off publication date of October 1955, using the following key words alone or in combination: "acute severe colitis", "ulcerative colitis", "drug therapy", "salvage therapy", "rescue therapy", "infliximab", "ciclosporin", "cyclosporin", "treatment outcomes", "Clostridium difficile", "cytomegalovirus", "thrombosis", "toxic megacolon"; (ii) The Cochrane Database of Systematic Reviews was searched for systematic reviews using the medical subject heading (MeSH): "ulcerative colitis"; (iii) The reference lists from all identified full publications; (iv) Abstracts presented at the United States Digestive Disease Week 2014/2015. The search strategy is outlined in Figure 1. All databases were last accessed in August 2015.

Figure 1.

Literature search strategy.

Both authors assessed study eligibility independently. To be eligible for inclusion, studies needed to include patients diagnosed with ASUC, fulfilling the Truelove and Witts' criteria, as well as patients hospitalised with severe UC, classified according to the Mayo scoring system or Lichtiger clinical activity index. Studies were excluded if patients had a subsequent diagnosis of Crohn's disease or indeterminate colitis.