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GI / Hepatology

Acute Severe Ulcerative Colitis

Truelove and Witts criteria, IV steroids, infliximab/ciclosporin rescue, surgical referral on day 3 if no response.

Source: BSG 2019; ECCO 2022

Step 1 of ~8
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Truelove and Witts Severity

Acute severe UC = ≥6 bloody stools/day + ANY systemic feature: fever >37.8°C, HR >90, Hb <105 g/L, ESR >30, CRP >30. Admit URGENTLY; combined GI + colorectal surgical care. Bloods (FBC, U&E, LFTs, CRP, ESR, Mg, group & save), blood + stool cultures, C diff PCR, CMV PCR, AXR (megacolon, mucosal islands, thumbprinting). Daily.

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only. Always apply local guidelines and clinical judgement.