Medical Management of Chronic Ulcerative Colitis

  • Stefan D. HolubarEmail author
  • Mattias Soop


In the twenty-first century, the management of inflammatory bowel disease can be considered a subspecialty within gastroenterology and colon and rectal surgery, “IBD-ology.” This is mainly due to the development of complex, expensive medical treatments such as biologic agents and management of patients with ileal pouch-anal anastomosis (IPAA). In this chapter, in Part 1 we introduce CUC and its definition, classifications, and epidemiology. Part 2 will review available medications, while Part 3 will present an algorithmic approach to CUC treatment. This chapter, intended for a surgical audience, aims to be a practical overview with clinical pearls rather than an exhaustive review.


Ulcerative colitis Crohn’s disease Indeterminate colitis Medical therapy 5-ASA Immunomodulators AZA 6MP Methotrexate Corticosteroids Biologic agents Infliximab Anti-TNF-alpha Anti-integrin Pouchitis Indeterminate pouchitis Ileal pouch-anal anastomosis 

Supplementary material

Video 46.1

“PillCam®” video clip demonstrating the camera within a translucent housing. Note the strobe lighting, which allows mucosal visualization. Courtesy of Dr. Stefan D. Holubar MD, MS. (MP4 4565 kb)

Copyright information

© ASCRS (American Society of Colon and Rectal Surgeons) 2019

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryCleveland ClinicClevelandUSA
  2. 2.Department of SurgerySalford Royal NHS Foundation TrustSalfordUK
  3. 3.Manchester Academic Health Science CenterThe University of ManchesterManchesterUK

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