Understanding Acute Severe Ulcerative Colitis

Acute severe ulcerative colitis is a complication of ulcerative colitis. It’s diagnosed when your disease flares and causes frequent bowel movements, bloody diarrhea, rapid heart rate, abdominal tenderness, fever, high levels of inflammation, bloating, and anemia. If you have it, you may need to be hospitalized depending on how severe your symptoms are.

People with acute severe ulcerative colitis are usually in the hospital for 4 to 12 days. Their treatment begins with diagnostic tests and intravenous fluids (IVs). Corticosteroids are usually used next, but they're not always effective.

If corticosteroids don't work within 3 to 5 days, you may be given immunosuppressive drugs like cyclosporine or infliximab. If your symptoms still don’t get better, your doctor may suggest surgery to remove all parts of your colon (a colectomy). 

Acute severe ulcerative colitis is more common in men ages 15 to 35. It usually happens within the first year of your diagnosis. About 20% of patients may need a colectomy after their first hospitalization. This increases to 40% after multiple hospital visits. Older patients, especially those over 80, have a higher risk of death.

Acute severe ulcerative colitis is a serious condition. It’s important for you to understand your options and get treated early. Make sure to educate yourself and communicate openly with your care team about any questions or concerns you may have.