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 & 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, its definition, classifications, and epidemiology. Part 2 will review available of 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 Immunodulators 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 (MOV 68600 kb)

Video 46.2

Pouchoscopy with stricture dilation video clip. Courtesy of Dr. Stefan D. Holubar MD, MS (MP4 70484 kb)


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© ASCRS (American Society of Colon and Rectal Surgeons) 2016

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Authors and Affiliations

  1. 1.Chief, Division of Colon & Rectal Surgery, Inflammatory Bowel Disease CenterDartmouth-Hitchcock Medical Center, The Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy & Clinical PracticeLebanonUSA
  2. 2.Department of Surgery, Salford Royal NHS Foundation TrustManchester Academic Health Science Center, The University of ManchesterManchesterUK

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