Intest Res.  2024 Jul;22(3):213-249. 10.5217/ir.2023.00050.

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023

• Yen HH
• Wu JF
• Wang HY
• Chang TA
• Chang CH
• Chang CW
• Chao TH
• Chou JW
• Chou YH
• Chuang CH
• Hsu WH
• Hsu TC
• Huang TY
• Hung TI
• Le PH
• Lin CC
• Lin CC
• Lin CP
• Lin JK
• Lin WC
• Ni YH
• Shieh MJ
• Shih IL
• Shun CT
• Tsai TJ
• Wang CY
• Weng MT
• Wong JM
• Wu DC
• Wei SC

• KMID: 2558187
• DOI: http://doi.org/10.5217/ir.2023.00050

Abstract

Ulcerative colitis (UC) is a chronic inflammation of the gastrointestinal tract and is characterized by alternating periods of inflammation and remission. Although UC incidence is lower in Taiwan than in Western countries, its impact remains considerable, demanding updated guidelines for addressing local healthcare challenges and patient needs. The revised guidelines employ international standards and recent research, emphasizing practical implementation within the Taiwanese healthcare system. Since the inception of the guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease has acknowledged the need for ongoing revisions to incorporate emerging therapeutic options and evolving disease management practices. This updated guideline aims to align UC management with local contexts, ensuring comprehensive and context-specific recommendations, thereby raising the standard of care for UC patients in Taiwan. By adapting and optimizing international protocols for local relevance, these efforts seek to enhance health outcomes for patients with UC.

Keyword

Ulcerative colitis; Management; Guidelines; Consensus; Taiwan

Figure

• 

  Fig. 1. Recommended algorithm for the treatment of UC. a1 g/day. b≥2 g/day. c≥1 g/day. d9 mg/day. e1.0–2.5 mg/kg/day. f0.45–1.5 mg/kg/day. gAnti-tumor necrosis factor (infliximab, adalimumab; golimumab), vedolizumab, ustekinumab, JAK inhihitors (tofacitinib, upadacitinib) or ozanimod. 5-ASA, 5-aminosalicylic acid; Tx, treatment; MMX, multi-matrix; UC, ulcerative colitis; AZA, azathioprine; 6-MP, 6-mercaptopurine; IV, intravenous.

• 

  Fig. 2. Recommended algorithm for the treatment of acute severe ulcerative colitis (UC). aComplete blood count, C-reactive protein, electrolytes, liver enzymes, hepatitis B virus, hepatitis C virus, etc; bStool culture, Clostridium difficile toxin, viruses; cMethylprodcisionle 1 mg/ kg/day or 60 mg/day, maximally, or hydrocortisone 100 mg×4 times daily, maximally; dTreatment failure, C-reactive protein >4.5 mg/dL & blood stool 3–8 times/day or bloody stool >8 times/day. TB, tuberculosis; CT, computed tomography; IV, intravenous; 5-ASA, 5-aminosalicylic acid.

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