Ulcerative Colitis Clinical Care Pathway
Make Diagnosis and Assess
Inflammatory Status
Assess Comorbidities and Disease-
and Therapy-Related Complications
Stratify According to Colectomy Risk
Outpatient
Inpatient
Inductive and Maintenance Therapy
(High Risk, Outpatient)
Inductive and Maintenance Therapy
(High Risk, Inpatient)
Therapy for High-Risk Outpatient
Not in Remission
1 2
3
Low-risk Patient
High-risk Patient
Inductive and
Maintenance Therapy
(Low Risk)
4
5
7
6
Assess Symptoms/Signs
• Bloody diarrhea
• Tenesmus
• Urgency
• Weight loss
• Fever
• Abdominal pain
• Joint swelling/
redness
• Localized
abdominal
tenderness
• Signs of anemia
• Cutaneous signs
Perform Lab
Testing
• CBC
• CMP
• CRP
• ESR
• C. difficile assay
• Stool cultures
Make Diagnosis and Assess Inflammatory Status
1
Perform
Colonoscopy/
Sigmoidoscopy
a
a
In patients with severe colitis, flexible sigmoidoscopy is safer and preferred over colonoscopy.
Figure 1
Select Imaging
Modalitites
(if indicated)
Identify Patient
Requiring
Hospitalization
AGA Institute Guideline on the Identification,
Assessment and Initial Medical Treatment of Ulcerative Colitis
