Miguel Regueiro, MD, on the Hospitalized Patient With Ulcerative Colitis

In this video Dr Regueiro discusses his presentation on caring for the hospitalized patient with ulcerative colitis from the AIBD regional meeting on September 11.

Miguel Regueiro, MD, is chair of the Digestive Disease and Surgery Institute at Cleveland Clinic in Cleveland, Ohio.

TRANSCRIPT:

I'm Dr. Miguel Regueiro. I'm chair for Digestive Disease and Surgery Institute at Cleveland Clinic in Cleveland, Ohio. I'm also the chair for the AIBD Regional sessions. I spoke on the hospitalized ulcerative colitis patient.

As we all know, this is sometimes one of the more challenging diseases to manage because these are patients who are quite sick with their ulcerative colitis. They're admitted to the hospital. Oftentimes, they've already been on steroids, like oral prednisone or mesalamine products.

We need to get our surgeons involved, and we need to consider how best to manage them. In my talk at AIBD regionals, I spoke on the hospitalized ulcerative colitis patients andome of the key take-home points were -- get your colorectal surgery team involved early, even if the patient never goes to surgery.

Always check for infection like C diff. Do an early sigmoidoscopy or limited colonoscopy to get a sense of the severity of the disease. In terms of treatment, if the patient has been bio-naive, not been on any therapy, we still use infliximab as a first-line for these hospitalized patients.

We had a discussion as to whether we use 5 milligram per kilogram or 10 milligram per kilogram. In my practice, I generally use the higher-dose infliximab, 10 milligram per kilogram. I'll give 2 doses within a week, but if they fail those, it is my opinion that they need to go to surgery.

Finally, we touched on a bit about some other agents that may be useful for the sick ulcerative colitis patients, such as tofacitinib and the role of tofacitinib, possibly in the future, in the hospitalized patients.

We should never forget that these patients can develop blood clots. We need to be aware of that and not be afraid to use low-molecular-weight heparin or other anticoagulants on our inpatients with ulcerative colitis. Thank you very much for your attention. I hope you had a chance to attend AIBD regionals. We'll see you soon.