Improved treatments for acute severe ulcerative colitis emerge

Acute severe ulcerative colitis (ASUC) is a serious condition that needs quick medical attention. Recent improvements in treatments have helped patients, but there are still challenges to reduce the need for surgery (colectomy). A key factor in deciding if a patient needs surgery is their response to corticosteroids within the first week of hospitalization. Data shows that patients who respond well have a much lower chance of needing surgery later. Other factors, such as previous use of immunomodulators, can increase the risk of surgery. Researchers are looking into new treatment options. Accelerated dosing of infliximab has been studied, but results show no major benefits over standard dosing for long-term outcomes. On the other hand, small molecules like JAK inhibitors may help patients who do not respond to steroids, but more research is necessary to ensure their safety. While cyclosporine can help patients achieve remission, maintaining that remission may involve using biologics. Some studies suggest that these treatments can keep patients from needing surgery. Additionally, researchers are exploring metabolic changes and other therapies, like nutritional support, although these methods still require more study. Bowel ultrasound is gaining attention as a way to assess the severity of ASUC non-invasively. Increased bowel wall thickness could indicate a need for additional treatment. Overall, rapid diagnosis and teamwork in patient care are crucial for managing ASUC. Researchers continue to seek better treatment strategies to improve patient outcomes and lower surgery rates.