Treatment Plan

Mild-Moderate:

Proctitis:

• Topical aminosalicylates for 4 weeks
• If no improvement: add oral aminosalicylates
• If still no improvement: add topical/oral corticosteroids for 4-8 weeks

Left-sided colitis:

• Topical aminosalicylates for 4 weeks
• If no improvement: add oral aminosalicylates (+/- oral corticosteroids for 4-8 weeks if
needed)

Extensive colitis:

• Combined topical and oral aminosalicylates for 4 weeks
• If no improvement: continue oral aminosalicylates plus topical/oral corticosteroids for
4-8 weeks

Moderate-Severe:

• Specialist management
• Consider biological treatments

Severe:

• Hospital admission
• IV hydrocortisone/methylprednisolone
• IV cyclosporine if contraindicated
• Surgery if no improvement within 72 hours

Maintenance therapy:

• Topical +/- oral aminosalicylates