Tauseef Ali, MD, on Acute Severe Ulcerative Colitis
Dr Ali recaps the key points of his presentation on managing acute severe ulcerative colitis from the American College of Gastroenterology scientific meeting.
Tauseef Ali, MD, is medical executive director of the Digestive Institute at SSM Health in Oklahoma City, Oklahoma.
TRANSCRIPT:
Hi, my name is Dr. Tauseef Ali. I'm a medical executive director for SSM Health, Crohn's and Colitis Center. During annual scientific meeting at ACG, I presented a topic on acute severe ulcerative colitis management.
I'm going to share some key take home messages with you. The critical part for all of us is to understand that 25% of patients with ulcerative colitis present either as an initial presentation or subsequent presentation with acute severe ulcerative colitis, and 40% of these patients can declare themselves steroid nonresponders.
During the first admission, 20% of the patients are at risk for colectomy, and that risk goes incrementally to 40% with the fourth admission with acute severe ulcerative colitis. That brings up the importance of early diagnosis, accurate diagnosis, triaging these patients on a timely fashion so that we can institute proper therapy and when needed or required we can offer them rescue therapy and also be aware that it is a multidisciplinary team approach and our surgeons need to be involved in the care so that timely surgery can also be planned.
We also learned that emergent colectomy is also associated with a risk of mortality. The risk of mortality also goes up when the patients are presenting with age above 50 years of age. The general mortality in acute severe ulcerative colitis is about 1%, and it can go as high as 4% if patients are above the age of 50.
I also discussed the importance of venous thromboembolism risk in these patients and offering them thromboprophylaxis with medical therapy along with the critical importance
of nutrition. Malnutrition is very important to address during the admission and studies have shown that if you add enteral nutrition to IV corticosteroid therapy It actually reduces your risk of steroid failure. Studies have shown that IV albumin itself does not improve outcomes, but enteral nutrition does.
I also touched base with some new rescue therapies that are being explored in the care of acute severe ulcerative colitis, including JAK inhibitors such as tofacitinib and upadacitinib and some other newer therapies that are being explored.
In the last segment of my presentation, I also explained how the future of acute severe ulcerative colitis looks like in terms of prognostic markers and identifying predictors of nonresponse using machine algorithms and learning algorithms and use of artificial intelligence.
My presentation should be available if you have registered for this meeting, and I would encourage you to listen to that. But these were some key take home messages during the annual scientific meeting. Thank you.
