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Management of severe or refractory ulcerative colitis in children and adolescents

Athos Bousvaros, MD
Mala Setty, MD
Jess L Kaplan, MD
Section Editor
Melvin B Heyman, MD, MPH
Deputy Editor
Alison G Hoppin, MD


Inflammatory bowel disease (IBD) is comprised of two major disorders, ulcerative colitis (UC) and Crohn disease (CD). These disorders have distinct pathologic and clinical characteristics (table 1), but their pathogenesis remains poorly understood. (See "Definition, epidemiology, and risk factors in inflammatory bowel disease".)

UC disease activity varies substantially among patients and over time. Among healthcare encounters for children with active UC, approximately 5 percent have acute severe colitis [1]. Some of these cases will be the initial manifestation of UC, while others represent exacerbations or "flares" of the chronic disease. The management of these patients is reviewed here. Other aspects of the diagnosis and management of children with UC are discussed in separate topic reviews:

(See "Clinical presentation and diagnosis of inflammatory bowel disease in children".)

(See "Important health maintenance issues for children and adolescents with inflammatory bowel disease".)

(See "Management of mild to moderate ulcerative colitis in children and adolescents".)

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Literature review current through: Nov 2017. | This topic last updated: Jun 13, 2017.
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