3rd May 2024

A 32-year-old female with a known history of ulcerative colitis presents with increased bloody diarrhoea, abdominal pain, and a recent weight loss.

A 32-year-old female with a known history of ulcerative colitis presents with increased bloody diarrhoea, abdominal pain, and a recent weight loss. She reports more than eight bloody stools per day and a nocturnal bowel movement. She appears fatigued and her initial vital signs reveal a pulse of 95 beats per minute and a temperature of 37.9ºC. Laboratory tests show a CRP of 35 mg/L and a haemoglobin level of 104 g/L. A diagnosis of acute severe ulcerative colitis is made.

Which is the most appropriate initial management?