Intensive care medicine

Inflammatory bowel disease

Infliximab

Internal medicine

Colectomy

Outpatient clinic

Medicine

Ulcerative colitis

General surgery

Disease

Ileostomy

BMJ Case Reports

A 72-year-old man presents with acute severe ulcerative colitis (ASUC), initially partially responsive to intravenous steroids and infliximab over a 3-day hospital stay. Following discharge and over the course of 15 days, his care was coordinated by the inflammatory bowel disease medical home team, who conducted clinical laboratory assessments and two outpatient flexible sigmoidoscopies to evaluate endoluminal disease activity and treatment response prior to proceeding with a laparoscopic total abdominal colectomy and creation of end ileostomy following medical failure. He was admitted to the hospital for a total of only 7 days, which included attempted medical management of ASUC, surgery and postoperative recovery.

Change in paradigm: impact of an IBD medical home on the outpatient management of acute severe ulcerative colitis