The Asia-Pacific consensus on ulcerative colitis

Choon Jin Ooi, Kwong Ming Fock, Govind K. Makharia, Khean Lee Goh, Khoon Lin Ling, Ida Hilmi, Wee Chian Lim, Thia Kelvin, Peter R. Gibson, Richard B. Gearry, Qin Ouyang, Jose Sollano, Sathaporn Manatsathit, Rungsun Rerknimitr, Shu Chen Wei, Wai Keung Leung, H. Janaka De Silva, Rupert Wl Leong

Research output: Contribution to journalReview articlepeer-review

111 Citations (Scopus)

Abstract

Inflammatory bowel disease (IBD) is increasing in many parts of the Asia-Pacific region. There is a need to improve the awareness of IBD and develop diagnostic and management recommendations relevant to the region. This evidence-based consensus focuses on the definition, epidemiology and management of ulcerative colitis (UC) in Asia. A multi-disciplinary group developed the consensus statements, reviewed the relevant literature, and voted on them anonymously using the Delphi method. The finalized statements were reviewed to determine the level of consensus, evidence quality and strength of recommendation. Infectious colitis must be excluded prior to diagnosing UC. Typical histology and macroscopic extent of the disease seen in the West is found in the Asia-Pacific region. Ulcerative colitis is increasing in many parts of Asia with gender distribution and age of diagnosis similar to the West. Extra-intestinal manifestations including primary sclerosing cholangitis are rarer than in the West. Clinical stratification of disease severity guides management. In Japan, leukocytapheresis is a treatment option. Access to biologic agents remains limited due to high cost and concern over opportunistic infections. The high endemic rates of hepatitis B virus infection require stringent screening before initiating immune-suppressive agents. Vaccination and prophylactic therapies should be initiated on a case-by-case basis and in accordance with local practice. Colorectal cancer complicates chronic colitis. A recent increase in UC is reported in the Asia-Pacific region. These consensus statements aim to improve the recognition of UC and assist clinicians in its management with particular relevance to the region.

Original languageEnglish
Pages (from-to)453-468
Number of pages16
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume25
Issue number3
DOIs
Publication statusPublished - 2010
Externally publishedYes

Keywords

  • Asia Pacific
  • Biologic agents
  • Consensus statements
  • Delphi
  • Diagnosis
  • Epidemiology
  • Inflammatory bowel disease
  • Leukocytapheresis
  • Management
  • Ulcerative colitis

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