Severe Ulcerative Colitis

Q: All of the following should be discontinued in severe ulcerative colitis (UC) except?

A) Anticholinergic drugs
 B) Antidiarrheal agent
 C) Nonsteroidal anti-inflammatory drugs (NSAIDs) 
D) Narcotics/opioid drugs 
 E) Enteral nutrition


Answer: E

The objective of the above question is to emphasize the importance of the continuation of enteral nutrition in severe UC. Holding off enteral nutrition in severe UC may harm the patient. Enteral nutrition should hold off only in fulminant disease. Enteral nutrition provides colon short-chain fatty acids needed for the repair of colon epithelial cells.

All of the other choices can lead to toxic megacolon and should be discontinued.

#gastroenterology
#nutrition



References:

1. González-Huix F, Fernández-Bañares F, Esteve-Comas M, et al. Enteral versus parenteral nutrition as adjunct therapy in acute ulcerative colitis. Am J Gastroenterol 1993; 88:227.

2. Roediger WE. The starved colon--diminished mucosal nutrition, diminished absorption, and colitis. Dis Colon Rectum 1990; 33:858.