The management of the hospitalized ulcerative colitis patient: the medical-surgical conundrum.

Abstract:

PURPOSE OF REVIEW:In this review article, we address emerging evidence for the medical and surgical treatment of the hospitalized patient with ulcerative colitis. RECENT FINDINGS:Ulcerative colitis is a chronic inflammatory disease involving the colon and rectum. About one-fifth of patients will be hospitalized from ulcerative colitis, and about 20-30%, experiencing an acute flare will undergo colectomy. Because of the significant clinical consequences, patients hospitalized need prompt evaluation for potential complications, stratification of disease severity, and a multidisciplinary team approach to therapy, which involves both the gastroenterologist and surgeon. Although corticosteroids remain first-line therapy, second-line medical rescue options, primarily infliximab or cyclosporine, are considered within 3-5 days of presentation. In conjunction, an early surgical consultation to present the possibility of a staged proctocolectomy as one of the therapeutic options is equally important. SUMMARY:A coordinated multidisciplinary, individualized approach to treatment, involving the patient preferences throughout the process, is optimal in providing patient-centered effective care.

authors

Levy LC,Coburn ES,Choi S,Holubar SD

doi

10.1097/MOG.0000000000000637

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

265-276

issue

4

eissn

0267-1379

issn

1531-7056

journal_volume

36

pub_type

杂志文章
  • Complications of bariatric surgery.

    abstract:PURPOSE OF REVIEW:Morbid obesity is an epidemic in the United States and parts of Europe, with severe health consequences. As the number of patients undergoing bariatric surgery has increased dramatically, it is crucial for the gastroenterologist caring for these patients to have a better understanding of the procedure...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e3282f094b5

    authors: Lee CW,Kelly JJ,Wassef WY

    更新日期:2007-11-01 00:00:00

  • Animal models of cholangiocarcinoma.

    abstract:PURPOSE OF REVIEW:Even though recent accumulated data can help to understand fundamental molecular mechanisms of progression of cholangiocarcinoma (CCA), its incidence and mortality still keep increasing worldwide with poor prognosis. As appropriate animal disease models are critical to fill the gap between the finding...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e32835d6a3e

    authors: Ko KS,Peng J,Yang H

    更新日期:2013-05-01 00:00:00

  • Cancer in inflammatory bowel disease: lessons from animal models.

    abstract:PURPOSE OF REVIEW:Human colitis-associated cancers (CAC) represent a heterogeneous group of conditions in which multiple oncogenic pathways are involved. In this article, we review the latest studies using genetic, chemical, bacterial and innate immune-mediated experimental models of CAC. RECENT FINDINGS:Using the azo...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e328354cc36

    authors: Sussman DA,Santaolalla R,Strobel S,Dheer R,Abreu MT

    更新日期:2012-07-01 00:00:00

  • Does everyone with inflammatory bowel disease need to be treated with combination therapy?

    abstract:PURPOSE OF REVIEW:This article describes the evolution of combination therapy in inflammatory bowel disease and how to determine when combination may not be necessary. RECENT FINDINGS:The combination of an immunosuppressive agent with an antibody to tumor necrosis factor has proven to be more effective than monotherap...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000281

    authors: Bernstein CN

    更新日期:2016-07-01 00:00:00

  • New clinical paradigms for treating and preventing antiplatelet gastrointestinal bleeding.

    abstract:PURPOSE OF REVIEW:To quantify antiplatelet-related gastrointestinal bleeding (GIB), characterize patients at greatest risk and summarize risk-management strategies emphasizing evolving knowledge in acute management of antiplatelet-related bleeding. RECENT FINDINGS:New paradigms for acute management of antiplatelet-rel...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000394

    authors: Abraham NS

    更新日期:2017-11-01 00:00:00

  • Viral infections of the gastrointestinal tract.

    abstract::Viral gastroenteritis is a major public health problem worldwide, and the number of identified pathogens continuously increases. Investigators have made considerable progress toward understanding both the epidemiology and the mechanisms of virus-cell interactions, host responses, and pathogenesis. A vaccine for the mo...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200001000-00003

    authors: Shaw RD

    更新日期:2000-01-01 00:00:00

  • Role of visceral fat in colonic inflammation: from Crohn's disease to diverticulitis.

    abstract:PURPOSE OF REVIEW:The composition of activated adipose tissue with adipocytes secreting a broad spectrum of immune-modulatory adipokines next to adipose tissue-derived stromal cells and professional immune effector cells in the visceral fat creates a complex network of inflammatory processes shaping local immune respon...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000324

    authors: Paeschke A,Erben U,Kredel LI,Kühl AA,Siegmund B

    更新日期:2017-01-01 00:00:00

  • Unique features of primary sclerosing cholangitis in children.

    abstract:PURPOSE OF REVIEW:To summarize publications on juvenile primary sclerosing cholangitis (PSC) published over the past 5 years. These studies contribute to the understanding of the clinical features, diagnostic pathways, genetic aspects, treatment and outcome of this condition. RECENT FINDINGS:Sclerosing cholangitis wit...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e3283388f5b

    authors: Mieli-Vergani G,Vergani D

    更新日期:2010-05-01 00:00:00

  • Gastroesophageal reflux disease.

    abstract::Globally, gastroesophageal reflux disease (GERD) remains a common and important clinical disorder. This review summarizes the major advances in the understanding and treatment of GERD that have been made in the past 12 months. Epidemiologic studies have yielded additional data on the clinical presentation and natural ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200307000-00009

    authors: Nguyen NQ,Holloway RH

    更新日期:2003-07-01 00:00:00

  • Portal hypertension.

    abstract:PURPOSE OF REVIEW:This review discusses the advances in the pathophysiology, diagnosis, and management of the complications of portal hypertension that have occurred in the past year. RECENT FINDINGS:The specific topics reviewed are the pathophysiology of portal hypertension (including recent findings regarding intrah...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200405000-00010

    authors: Garcia-Tsao G

    更新日期:2004-05-01 00:00:00

  • Colonic and anorectal motility testing in the high-resolution era.

    abstract:PURPOSE OF REVIEW:The past few years have seen an increase in the number of research and clinical groups around the world using high-resolution manometry (HRM) to record contractile activity in the anorectum and colon. Yet despite the uptake and growing number of publications, the clinical utility and potential advanta...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000229

    authors: Dinning PG,Carrington EV,Scott SM

    更新日期:2016-01-01 00:00:00

  • Rotavirus vaccines and intussusception risk.

    abstract:PURPOSE OF REVIEW:Rotavirus infection is the leading cause of severe dehydrating gastroenteritis, responsible for an estimated 440,000 deaths per year in children less than 5 years of age worldwide. There was great optimism when the first rotavirus vaccine was licensed in the United States in July 1998 (rhesus rotaviru...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:

    authors: Bines JE

    更新日期:2005-01-01 00:00:00

  • Mucosal healing in Crohn's disease and ulcerative colitis: what does it tell us?

    abstract:PURPOSE OF REVIEW:To provide a critical review of the literature concerning the significance of mucosal healing as a predictor of future clinical and endoscopic course in patients with inflammatory bowel disease. Particular focus is given to articles published within the last year. RECENT FINDINGS:In patients with Cro...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e3283455c8f

    authors: Flynn A,Kane S

    更新日期:2011-07-01 00:00:00

  • Food allergy and irritable bowel syndrome.

    abstract:PURPOSE OF REVIEW:Irritable bowel syndrome is a common and likely a multifactorial gastrointestinal disorder in which a disturbed brain-gut axis has been thought to have a mandatory role. Recent clinical and experimental studies imply that dietary factors may be more important in the pathogenesis of irritable bowel syn...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/01.mog.0000181712.81657.0a

    authors: Kalliomäki MA

    更新日期:2005-11-01 00:00:00

  • The assessment and management of defecatory dysfunction: a critical appraisal.

    abstract:PURPOSE OF REVIEW:To summarize the advances in diagnostic modalities and management options for defecatory dysfunction and highlight the areas in need of further research. RECENT FINDINGS:The diagnostic utility of high-resolution anorectal manometry (ARM), which has emerged as a promising tool for the diagnosis of def...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000407

    authors: Neshatian L

    更新日期:2018-01-01 00:00:00

  • Endoscopic resection of early gastric cancer: the Japanese perspective.

    abstract:PURPOSE OF REVIEW:To examine recent advances in the techniques and technologies of endoscopic resection of early gastric cancer. RECENT FINDINGS:Endoscopic mucosal resection of early gastric cancer with no risk of lymph node metastasis has been a standard technique in Japan and is increasingly becoming accepted and re...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/01.mog.0000239873.06243.00

    authors: Gotoda T

    更新日期:2006-09-01 00:00:00

  • Inflammatory bowel disease pathogenesis: what is new?

    abstract:PURPOSE OF REVIEW:Knowledge on and understanding of the pathophysiology of inflammatory bowel disease (IBD) is continuously growing. Important insights from the last years are summarized in this review. RECENT FINDINGS:Further genetic risk factors for IBD have been identified and confirmed. Novel studies analyzing the...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e328353e61e

    authors: Scharl M,Rogler G

    更新日期:2012-07-01 00:00:00

  • Psychological factors and weight loss in bariatric surgery.

    abstract:PURPOSE OF REVIEW:Morbid obesity is associated with a high prevalence of psychopathological conditions that might have an impact on postsurgery outcomes. This review summarizes recent data about psychological disorders in obese patients before and after bariatric surgery as well as the assessment and impact of these fa...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e3283422482

    authors: Pataky Z,Carrard I,Golay A

    更新日期:2011-03-01 00:00:00

  • Fatty liver and the metabolic syndrome.

    abstract:PURPOSE OF REVIEW:Nonalcoholic fatty liver disease and its subset nonalcoholic steatohepatitis represent the liver manifestations of insulin resistance. This review briefly summarizes advances in our understanding of the pathogenesis of nonalcoholic fatty liver disease and its prevalence, natural history and treatment....

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e32801421a9

    authors: Neuschwander-Tetri BA

    更新日期:2007-03-01 00:00:00

  • Small intestinal motility.

    abstract:PURPOSE OF REVIEW:The aim of this article is to review recently published studies presenting novel and relevant information on small intestinal motility. RECENT FINDINGS:The reviewed studies covered a variety of topics with several themes emerging. The presentation and causes of chronic intestinal dysmotility continue...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e32801424f3

    authors: Bratten JR,Jones MP

    更新日期:2007-03-01 00:00:00

  • Sphincter of Oddi dysfunction: sphincter of Oddi dysfunction or discordance? What is the state of the art in 2018?

    abstract:PURPOSE OF REVIEW:To review important manuscripts published over the previous 2 years relative to sphincter of Oddi dysfunction (SOD). RECENT FINDINGS:The long-term outcomes of the Evaluating Predictors and Interventions of SOD (EPISOD) trial further substantiated results from the initial EPISOD study, reinforcing tha...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000455

    authors: Hyun JJ,Kozarek RA

    更新日期:2018-09-01 00:00:00

  • Approaches to endoscopic ampullectomy.

    abstract:PURPOSE OF REVIEW:Ampullary tumors, usually adenomas, are often encountered during endoscopic evaluation, especially in patients with familial adenomatous polyposis (FAP). Because of the risk of progression to adenocarcinoma, ampullary adenomas should be treated. Endoscopic therapy is an appropriate option and recent e...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200409000-00008

    authors: Wong RF,DiSario JA

    更新日期:2004-09-01 00:00:00

  • Mutations of isocitrate dehydrogenase 1 and 2 in intrahepatic cholangiocarcinoma.

    abstract:PURPOSE OF REVIEW:Exome sequencing studies have recently expanded the genetic characterization of intrahepatic cholangiocarcinomas. Among a number of novel genes, isocitrate dehydrogenase (IDH) is recurrently mutated in intrahepatic cholangiocarcinomas. We review the effects of these mutations on several biochemical pa...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000050

    authors: Grassian AR,Pagliarini R,Chiang DY

    更新日期:2014-05-01 00:00:00

  • Complementary and alternative medicine and gastrointestinal diseases.

    abstract::Complementary and alternative medicine (CAM) is becoming increasingly utilized as a form of health care, with recent studies suggesting that over 40% of Americans use some form of CAM. This has major financial implications for the health care industry. Traditional physicians frequently are unaware of CAM use by their ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200003000-00016

    authors: Haas L,McClain C,Varilek G

    更新日期:2000-03-01 00:00:00

  • New advances in pancreatic imaging.

    abstract:PURPOSE OF REVIEW:Exciting new developments and applications of imaging techniques in pancreatic diseases have emerged. This review discusses these new advances and how they are improving our ability to diagnose malignancies and inflammatory lesions, to grade severity of pancreatitis, and to stage pancreatic cancer acc...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/01.mog.0000174223.74783.1b

    authors: Kwon RS,Brugge WR

    更新日期:2005-09-01 00:00:00

  • Endoscopic management of biliary disease.

    abstract::Therapeutic biliary endoscopy continues to evolve. Key articles this year primarily involve biliary stenting and biliary stone removal, the two important maneuvers available to the biliary endoscopist. The issues addressed in this review include follow-up after the use of multiple stents for benign strictures, unilate...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200205000-00013

    authors: Barnett JL

    更新日期:2002-05-01 00:00:00

  • Autoimmune pancreatitis.

    abstract:PURPOSE OF REVIEW:Autoimmune pancreatitis (AIP) is an increasingly recognized clinical condition. Our objective is to provide a concise review of the advances in the past year in our understanding of AIP. RECENT FINDINGS:In a hospital survey from Japan, the prevalence of AIP was estimated at 0.82 per 100,000 individua...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e32830b10d2

    authors: Pannala R,Chari ST

    更新日期:2008-09-01 00:00:00

  • Molecular classification of cholangiocarcinoma.

    abstract:PURPOSE OF REVIEW:Cholangiocarcinoma (CCA) are heterogeneous tumors that arise from the malignant transformation of cholangiocytes along the biliary tree. CCA heterogeneity occurs at multiple levels and results in resistance to therapy and poor prognosis. Here, we review the molecular classification of CCA by focusing ...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0000000000000611

    authors: Louis C,Papoutsoglou P,Coulouarn C

    更新日期:2020-03-01 00:00:00

  • Obesity pharmacology: past, present, and future.

    abstract::Over the past several years, the pharmacologic treatment of obesity has undergone changes in safety, efficacy, and therapeutic targeting. The prevalence of cardiac valvulopathy associated with treatment with phentermine, fenfluramine, and dexfenfluramine is now becoming clarified with the publication of longer-term st...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章

    doi:10.1097/00001574-200203000-00011

    authors: Kushner RF,Manzano H

    更新日期:2002-03-01 00:00:00

  • Eosinophilic esophagitis: diagnostic tests and criteria.

    abstract:PURPOSE OF REVIEW:To present the clinical, endoscopic, and histologic features of eosinophilic esophagitis (EoE), review the current diagnostic guidelines for EoE, and present an approach for diagnosis of EoE. It will also highlight selected techniques that are under development that may be useful in the future for dia...

    journal_title:Current opinion in gastroenterology

    pub_type: 杂志文章,评审

    doi:10.1097/MOG.0b013e328352b5ef

    authors: Dellon ES

    更新日期:2012-07-01 00:00:00