1st Edition

Ulcerative Colitis The Complete Guide to Medical Management

By Gary R. Lichtenstein Copyright 2011

    Ulcerative Colitis: The Complete Guide to Medical Management serves as the definitive source for medical management of ulcerative colitis (UC).

    Dr. Gary R. Lichtenstein, along with Dr. Ellen J. Scherl, have collaborated with over 60 experts from around the world to provide gastroenterologists and those in training with the necessary information to successfully manage the patient with ulcerative colitis.

    Sections Include:
    • General
    o The role of the FDA in drug development; pediatric considerations; disease modifiers; and more
    • Medications
    o Antibiotic use in treatment of UC; oral novel biological therapies for UC; calcineurin inhibitors use in UC; novel biologic and non-biologic therapy for UC; and more
    • Specific Clinical Presentations
    o Medical management of toxic megacolon; management of extraintestinal manifestations; medical therapy of left-sided UC; use of prebiotics and probiotics; maintenance of remission; and more

    • Color images, graphs, and tables
    • Extensive index that includes cross-referencing to Crohn’s Disease: The Complete Guide to Medical Management
    • Comprehensive references at the end of each chapter

    Organized into an easy-to-reference format, Ulcerative Colitis: The Complete Guide to Medical Management threads theory into practice and provides gastroenterology professionals with the most comprehensive information available.

    The other side of inflammatory bowel disease is covered in Drs. Gary R. Lichtenstein and Ellen J. Scherl’s Crohn’s Disease: The Complete Guide to Medical Management. All gastroenterologists will find both books to be essential for future practice in the treatment and care of their patients with either Crohn’s disease or ulcerative colitis, as well as in the overall management of those with inflammatory bowel disease.



    About the Editor and Associate Editor

    Contributing Authors


    Prologue Historical Perspective of Ulcerative Colitis

    Ming V. Lin, MD; Wojciech Blonski, MD, PhD; David Kotlyar, MD; and Gary R. Lichtenstein, MD,


    Section I General

    Chapter 1 The Natural History of Inflammatory Bowel Disease

    Pietro G. Andres, MD and Lawrence S. Friedman, MD

    Chapter 2 Clinical Research in Inflammatory Bowel Disease: Placebo Response in Clinical Trials

    Chinyu Su, MD and James D. Lewis, MD, MSCE

    Chapter 3 The Role of the FDA in Drug Development in Inflammatory Bowel Disease

    Alan C. Moss, MD, FACG and Adam S. Cheifetz, MD

    Chapter 4 Utility of Animal Models for the Study and Treatment of Inflammatory Bowel Disease

    Ashish Chawla, MD and Kenneth Simpson, BVM&S, PhD

    Chapter 5 Pediatric Considerations in Medical Therapy in Patients With Inflammatory Bowel Disease

    Louis R. Ghanem, MD, PhD and Robert N. Baldassano, MD

    Chapter 6 The Limitations of Applying Evidence-Based Medicine to Inflammatory Bowel Disease:

    What We Do Not Learn From Clinical Trials

    Joshua R. Korzenik, MD and Corey A. Siegel, MD

    Chapter 7 Disease Modifiers in Inflammatory Bowel Disease

    Jaime A. Oviedo, MD and Francis A. Farraye, MD, MSc, FACP, FACG

    Chapter 8 Fertility and Pregnancy in Inflammatory Bowel Disease

    Jeffry A. Katz, MD and Vinita Elizabeth Jacob, MD

    Chapter 9 Diversion Colitis

    Eugeni Dom\u00e8nech, MD, PhD and Miguel A. Gassull, MD, PhD

    Chapter 10 Medication Adherence in Inflammatory Bowel Disease

    Sunanda V. Kane, MD, MSPH, FACG, FACP, AGAF

    Section II Medications

    Chapter 11 General Principles of Medical Therapy of Ulcerative Colitis

    Sonia Friedman, MD, FACP

    Chapter 12 Assessment of Disease Activity in Ulcerative Colitis

    Anthony L. Rosa, MD and Thomas A. Judge, MD

    Chapter 13 Current and Future Oral Mesalamine Derivative Use in Ulcerative Colitis

    Lloyd Sutherland, MDCM, MSc, FRCP(C), FACP

    Chapter 14 Current and Future Topical Mesalamine Derivatives in Ulcerative Colitis

    Jeffrey W. Nathanson, MD and Russell D. Cohen, MD

    Chapter 15 Antibiotics in Ulcerative Colitis

    Kim L. Isaacs, MD, PhD

    Chapter 16 Oral and Parenteral Corticosteroids in Ulcerative Colitis

    Leonard Baidoo, MD and Gary R. Lichtenstein, MD, FACP, FACG, AGAF

    Chapter 17 Topical Corticosteroid Use in Ulcerative Colitis

    Seymour Katz, MD, FACP, MACG

    Chapter 18 6-Mercaptopurine and Azathioprine Use in Ulcerative Colitis

    Marla C. Dubinsky, MD

    Chapter 19 Azathioprine Metabolism in Inflammatory Bowel Disease:

    A PhysicianÆs Guide to Metabolite Testing

    Carmen Cuffari, MD

    Chapter 20 Methotrexate in the Treatment of Ulcerative Colitis

    Ellen J. Scherl, MD, FACP, AGAF; Vinita Elizabeth Jacob, MD; Brian P. Bosworth, MD;

    Ryan Urquhart Warren, MD; and Harrison Lakehomer, BA

    Chapter 21 Calcineurin Inhibitors (Cyclosporine, Tacrolimus, Sirolimus) and Mycophenolate Motefil Use in

    Ulcerative Colitis

    Hans Herfarth, MD, PhD and J\u00fcrgen Sch\u00f6lmerich, MD, PhD

    Chapter 22 Infliximab Use in Ulcerative Colitis

    Wojciech Blonski, MD, PhD; Antoni Stadnicki, MD, PhD; Gary R. Lichtenstein, MD, FACP, FACG, AGAF;  


    Gary R. Lichtenstein, MD,FACP, FACG, AGAF is the Director of the Inflammatory Bowel Disease Center and a Professor of Medicine in the Gastrointestinal Division of the Department of Medicine at the Hospital of the University of Pennsylvania and the University of Pennsylvania School of Medicine in Philadelphia, Pennsylvania.     

    Dr. Lichtenstein earned his medical degree from the Mount Sinai School of Medicine in New York, New York. He then completed his internship and residency in Internal Medicine at Duke University Medical Center in Durham, North Carolina. He also served a fellowship in Gastroenterology at the Hospital of the University of Pennsylvania of the University Of Pennsylvania School of Medicine. His current research interests encompass investigational therapies for the treatment of ulcerative colitis and Crohn’s disease. Dr. Lichtenstein has received numerous research grants focusing on these areas and has served as the national/international principal investigator evaluating novel agents for therapeutic trials in the treatment of ulcerative colitis and Crohn’s disease.   

    A Fellow of the American Gastroenterological Association, the American College of Physicians, and the American College of Gastroenterology, Dr. Lichtenstein has served as Medical Secretary for the American Board of Internal Medicine, Gastroenterology Section. He holds membership and committee positions in many professional societies at a national level, including the American Gastroenterological Association, where he has served as the vice-chair of the Clinical Practice Committee and Practice Economics Committee and where he has served as chair of the Clinical Practice Committee; the American Society for Gastrointestinal Endoscopy, where he has served on the Committee on Training; and the American College of Gastroenterology, where he has served on the Education Committee, Programs Committee, and the Nominations Committee. He recently served as a member of the Research Committee. He has been the chair of the Abstract Review Committee for Inflammatory Bowel Disease for the American College of Gastroenterology. He is also a member of the Crohn’s and Colitis Foundation of America, where he serves at the national level as the chair of the Membership Committee of the Clinical Research Alliance; he has served on the National Grants Review Committee and the National Physician Education Committee as well. Additionally, Dr. Lichtenstein is a longstanding member of the American College of Physicians and the American Medical Association.    

    Dr. Lichtenstein has received numerous awards. including the award for the top specialist in the University of Pennsylvania Health System—the Louis A. Duhring Award. He is the recipient of the Christina and Marie Lindback award, which is the top teaching award in the entire University of Pennsylvania. He has received Penn Pearls Award for medical school teaching. He has received the Donald B. Martin Teaching Award for the Department of Medicine Housestaff. He has received the Sidney Cohen Teaching Award for the Gastroenterology Division. He is listed in “The Best Doctors in America” for Inflammatory Bowel Disease, and was listed among the Top Gastroenterologists for the Elderly in Philadelphia and Top Gastroenterologists in Philadelphia (Special Focus: Inflammatory Bowel Disease) by Philadelphia Magazine. He is the recipient of the CCFA Physician of the Year Award, Philadelphia and Delaware Valley Chapters.    

    In addition to having served on the Editorial Board of GastroenterologyAmerican Journal of Gastroenterology, Inflammatory Bowel Diseases, World Journal of Gastroenterology,and Digestive Diseases and Sciences, Dr. Lichtenstein is the current section editor of Selected Summaries and the section editor of Print and Media Review in Gastroenterology. He has served as a reviewer for such journals as The New England Journal of Medicine, Gastroenterology, The Lancet, the Annals of Internal Medicine, Gut, Journal of Parenteral and Enteral Nutrition, the American Journal of Gastroenterology, the World Journal of Gastroenterology and the Journal of Clinical Gastroenterology. He is the executive editor of the newly indexed journal Gastroenterology and Hepatology, and serves as Associate Editor of Therapeutic Advances in Gastroenterology, The Physician and Sportsmedicine,and Clinical Investigation, and is currently Assistant Editor-in-Chief of the World Journal of Gastroenterology. An invited lecturer at the local, national, and international levels, Dr. Lichtenstein is the author or co-author of more than 250 peer-reviewed primary articles, chapters, letters, and editorials, and he has presented over 250 abstracts and edited 18 books. He has lectured at over 300 invited conferences, symposiums, and institutional grand rounds.    

    Ellen J. Scherl, MD, FACP, AGAF
    , is the Jill Roberts Associate Professor of Clinical Medicine and Director of The Jill Roberts Center for Inflammatory Bowel Disease at Weill Medical College of Cornell University/New York-Presbyterian Hospital. She holds a bachelor’s degree in English from Barnard College, Columbia University, and a medical degree from New York Medical College. She is a fellow of the American College of Physicians and the American Gastroenterological Association (AGA), a member of the American Society of Gastrointestinal Endoscopy, and a past president of the New York Society for Gastrointestinal Endoscopy (NYSGE). She is currently Vice President of the New York Academy of Gastroenterology.     

    Dr. Scherl is Chairperson of the New York Chapter of the Crohn’s and Colitis Foundation of America and is involved in the New York Crohn’s Foundation. She received the 2008 AGA Outstanding Women in Science award and the 2006 NYSGE Florence Lefcourt Distinguished Service Award, and has been awarded by the Crohn’s and Colitis Foundation of America. She is an American Society of Gastrointestinal Endoscopy Circle of Life Member and a member of the AGA Legacy Society. She is board certified in medicine and gastroenterology.    

    Dr. Scherl is an editorial reviewer for IBD Journal, Journal of Clinical Gastroenterology, Gastrointestinal Endoscopy, Digestive Diseases and Sciences, and Journal of Gastroenterology and Hepatology. She is co-author of the chapter “Crohn’s Disease of the Small Intestine” in Gastroenterology and Hepatology: The Comprehensive Visual Reference, associate editor of Inflammatory Bowel Disease: The Complete Guide to Medical Management, and coauthor of An Interactive Dialogue on IBD.    Dr. Scherl established the first IBD tissue bank in New York City at Weill Medical College of Cornell University/New York-Presbyterian Hospital. She has extensive experience as an investigator in clinical trials and is currently participating in national multicenter trials and in investigator-initiated trials focusing on ulcerative colitis and Crohn’s disease.