Free, independent CPD for Irish doctors by Irish doctors

Ulcerative colitis: A Practical Approach

By

• Prof Anthony O’Connor

Reviewed by: Priscilla Lynch

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About this Module

This module provides a practical overview of ulcerative colitis (UC), from recognising the clinical presentation and establishing the diagnosis to selecting appropriate treatment and monitoring disease activity.

The module explores the epidemiology and aetiology of UC, key differences between UC and Crohn’s disease, and the importance of recognising extraintestinal manifestations. It outlines an evidence-based approach to investigating patients with gastrointestinal symptoms, including the role of inflammatory markers, faecal calprotectin, endoscopy and histology, while highlighting important differential diagnoses and red-flag features.

Participants will review current treatment strategies according to disease extent and severity, including aminosalicylates, corticosteroids, immunomodulators and biologic therapies. The module also examines newer treatment options, including selective IL-23 inhibitors and JAK inhibitors, and considers factors that influence treatment selection and safety.

Particular attention is given to monitoring treatment response and the importance of achieving sustained, steroid-free remission. The module discusses the role of clinical, biochemical and endoscopic assessment, alongside strategies for recognising treatment failure and avoiding inappropriate escalation when symptoms may have another cause.

The module also covers long-term complications of UC, including colorectal cancer risk, infection, osteoporosis and treatment-related adverse effects, as well as the role of colorectal surveillance and vaccination.

Finally, through a clinical case, participants will learn how to recognise and manage acute severe ulcerative colitis (ASUC), including the importance of urgent investigation, intravenous corticosteroid treatment, early assessment of response and timely escalation to rescue therapy or surgery.

Learning outcomes

On completion of this module, participants should be able to:

• Recognise the typical clinical presentation and key differential diagnoses of UC.
• Describe an appropriate diagnostic and investigative approach to suspected UC.
• Differentiate the main anatomical patterns and assess disease severity.
• Outline current medical treatment options for UC and principles of treatment escalation.
• Apply appropriate strategies for monitoring disease activity and maintaining remission.
• Recognise important complications of UC and treatment-related risks, including colorectal cancer and infection.
• Identify ASUC and understand the principles of urgent medical and surgical management.
• Recognise when specialist multidisciplinary input or surgical referral is required.

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Module Steps

To earn CME credit, follow these steps:

• Listen to the podcast.
• Complete the 5 MCQs that follow. After each question, you will be able to see whether you answered correctly and will then read evidence-based information that supports the most appropriate answer choice. These questions are part of the educational content and are designed to challenge you. You will not be penalised for answering the questions incorrectly.
• Complete the 10 True or False questions in the Post-Module Assessment. These questions are designed to demonstrate that the module has improved your knowledge base on this topic.
• On attaining a score of 70% or more on the Post-Module Assessment, the assigned CPD credits will be logged to your personal CPD activity log. You may view or print a verification certificate when required or print off an email stating the name of the module, the author details and the CPD hours. You will not be able to alter the certificate or log. The credit that you receive is based on your user profile.
• By providing information on how the module has enhanced your knowledge and/or practice, you may qualify for additional CPD credits during a CPD review.
• DoctorCPD encourages you to complete the Activity Evaluation to provide feedback to guide us in the future development of this site.

Each DoctorCPD module is designed to be completed within the time designated on the Module Introduction page. This is an estimate of the maximum time required to complete the specific module and is determined by the format and content of the module. Users should claim only those credits that reflect the time actually spent on the activity.

To successfully earn credit, participants must complete the activity online, and receive a minimum score of 70% on the post-module assessment.