Medical management of ulcerative colitis

The management of ulcerative colitis is a often a challenge to the physician with a wide degree of variation in symptoms and extent of disease complicating the clinical picture. Once a differential diagnosis has been reached, treatment for mild to moderate colitis can be with topical or oral steroids supplementing topical or oral aminosalicylates. For more severe disease, hospitalisation followed by intravenous steroids may be necessary. The addition of cyclosporin may prevent the need to perform colectomy. Maintenance with steroids does not work so aminosalicylates and immunomodifying drugs such as azathioprine are the mainstay. However it is important that adequate doses are used.