Ulcerative Colitis

Ulcerative colitis (UC) is characterized by chronic inflammation of the intestine. Complications of longstanding disease include an increased risk of development of dysplasia, colorectal cancer (CRC), and formation of strictures. Current therapies include 5‐ aminosalicylates (5‐ASA), corticosteroids, immunosuppressives, and biologics. While tumor necrosis factor (TNF) antagonists have dominated the treatment of inflammatory bowel disease (IBD), the advent of novel biologics such as anti‐integrins as well as small oral molecules has revolutionized the treatment landscape. The chapter summarizes epidemiology, treatment goals, and key data for existing and novel compounds. In observational studies, mucosal healing has been consistently associated with improved outcomes, including clinical remission, hospitalization, and abdominal surgery. The chapter shows the algorithm for management of distal ulcerative colitis and more extensive ulcerative colitis. The choice of interventions for treatment of more extensive colitis should be made after classifying the clinical disease severity as mild, moderate, or severe.