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Acute Severe Ulcerative Colitis Management (ECCO/AGA)

Acute Severe Ulcerative Colitis Management (ECCO/AGA): Acute Severe UC (Truelove-Witts) → Hospital Admission → Day 3 Assessment (Oxford Criteria) → Resp...

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. ▶
    Start

    Acute Severe UC (Truelove-Witts)

    ≥6 bloody stools/day + systemic toxicity

    1. ●
      Action

      Hospital Admission

      IV steroids, VTE prophylaxis, surgical consult

      • Hydrocortisone 100mg QID or methylpred
      • NPO if toxic megacolon
      • Daily stool frequency, CRP
      1. ◆
        Decision

        Day 3 Assessment (Oxford Criteria)

        CRP and stool frequency

        1. ●
          Action

          Responding

          Continue IV steroids, plan transition

          1. ■
            End

            Transition to Oral Steroids

            Add maintenance therapy

        2. ●
          Action

          Not Responding

          >8 stools or CRP>45 with 3-8 stools

          1. ◆
            Decision

            Rescue Therapy

            • Infliximab
            • Cyclosporine
            • Surgery
            1. ●
              Action

              Infliximab

              5-10 mg/kg, accelerated dosing

              1. ■
                End

                Subtotal Colectomy

                If rescue fails or perforation/megacolon

Guideline Source

ECCO Acute Severe Ulcerative Colitis Guidelines

DOI: 10.1093/ecco-jcc/jjaa001View Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Truelove-Witts criteria define severity
  • Day 3 response assessment critical
  • Surgical backup essential

Applicable Regions

USAUUKEU

EU: ECCO guidelines standard

US: AGA guidelines

Version 1Next review: 2028-01-01

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Management

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Frequently Asked Questions

What is the Acute Severe Ulcerative Colitis Management (ECCO/AGA)?

The Acute Severe Ulcerative Colitis Management (ECCO/AGA) is a management clinical algorithm for Colorectal Surgery. It provides a structured decision tree to guide clinical decision-making, based on ECCO Acute Severe Ulcerative Colitis Guidelines.

What guideline is the Acute Severe Ulcerative Colitis Management (ECCO/AGA) based on?

This algorithm is based on ECCO Acute Severe Ulcerative Colitis Guidelines (DOI: 10.1093/ecco-jcc/jjaa001).

What are the limitations of the Acute Severe Ulcerative Colitis Management (ECCO/AGA)?

Known limitations include: Truelove-Witts criteria define severity; Day 3 response assessment critical; Surgical backup essential. Individual patient factors may require deviation from these recommendations.

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