Alessio Morley-Fletcher (1), Athos Bousvaros (2), Annalisa Aratari (3), Valeria Clemente (3), Claudio Papi (3)
1Pediatric Gastroenterology and Nutrition Massachusetts General Hospital for Children Harvard Medical School, Boston, MA -USA 2Pediatric Gastroenterology and Nutrition Children’s Hospital Boston Harvard Medical School, Boston, MA - USA3U.O.C. Gastroenterologia e Epatologia, A.O. San Filippo Neri di Roma
Il punto di vista del pediatra Although pediatric Ulcerative Colitis (UC) shares many similarities with adult-onset UC, some aspects of this challenging condition are unique to children. The initial treatment of the hospitalized child includes supportive care, intravenous steroids, and sometimes antibiotics. If there is no improvement after 7 days either surgery or medical rescue therapies should be considered. Discussion with the family about the risks and benefits of medical vs. surgical therapy allows for a joint decision. Il punto di vista del Gastronterologo dell’Adulto Severe ulcerative colitis should be immediately recognised and managed in hospital. The “Oxford regimen” based on high dose of intravenous steroids, early recognition of prognostic factors and early colectomy have improved the outcome of this condition. In steroid-refractory patients cyclosporine and infliximab are possible rescue therapies. Colectomy remains a valid option for complications and no response to medical therapies.