The management of ulcerative colitis.

The modern medical and surgical treatment of ulcerative colitis has been detailed. Whilst improvements in medical management have been few in the past decade there have been advances in dietary management and in the use of new drugs such as azathioprine and disodium cromoglycate which are currently being evaluated. Sulphasalazine remains a valuable drug in treating attacks of the disease and in preventing relapses, and its mode of action is now better understood. Steroid therapy, used orally, parenterally or topically, is of value in managing acute colitic attacks. Surgery is often required and total proctocolectomy with ileostomy remains the operation of choice. Colectomy with ileorectal anastomosis still remains a controversial operation but has its enthusiastic advocates. The interesting a new operation of proctocolectomy, with the establishment of an ileal bladder and continent ileostomy, is being assessed in Sweden and in a few centres in Britain and America.