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Dr Aakash Aggarwal
Dr Vivek Ahuja
Dr Gaurav Singal
Dr Prateek Sharda
Dr Madhur Sharma


UC (Ulcerative colitis), ASUC (Acute Severe Ulcerative Colitis), ruelove & Witts diagnostic criteria, thrombocytosis


Background: Ulcerative colitis (UC) is an idiopathic inflammatory disease predominantly involving colo-rectum. About 1/5th of UC patients presents in the form of acute severe ulcerative colitis (ASUC) which carries a significant morbidity and mortality. It is diagnosed on the basis of Truelove and Witts criteria.

Materials and Methods: A total of 30 consecutive patients diagnosed to have ASUC according to Truelove & Witts criteria were enrolled in study. Their clinical and laboratory parameters were determined which included CBC, RFT, LFT, ESR, CRP – quantitative, albumin and stool for clostridium difficle. Study duration was 15 months, from November 2022 to January 2024.

Results: Mean age of the patients was 38.83 ± 13.35 years. 19/30 (63.3%) were males and 11/30 (36.6%) were females. Among the 30 total patients, 20 (66.6%) had preexisting ulcerative colitis and 10 (33.3%) had new onset disease with first presentation as ASUC. Most common cause of flare was poor compliance to medical treatment (n=17/20; 85%) followed by NSAID use (n=2/20; 10%) and supra added clostridium difficle infection (n=1/20; 5%). When Truelove & Witts criteria was applied, along with >6 bowel movements with visible blood most common additional feature was raised ESR (> 30 mm/hour), seen in 24 (80%) patients. It was followed by tachycardia (pulse rate >90/minute), seen in 20 (66.6%) patients.  Anaemia i.e. hemoglobin < 10.5 g% was present in 16 (53.3%) patients and fever (> 100.04°F) was present in 8 (26.6%) patients.

Most common clinical features were pain abdomen (n=25; 83.3%), followed by stool urgency (n=18; 60%) and tenesmus (n=7; 23.3%). Thrombocytosis was seen in (n=4; 13.3%) patients and hypoalbuminemia was seen in (n=11; 36.6%) patients.

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