Colorectal cancer surveillance: https://web.pathway.md/diseases/recPfEbvwZ5o0OFe2 14/18 6/29/23, 3:46 AM Ulcerative colitis Pathway As per ACG 2019 guidelines, consider obtaining colonoscopic screening and surveillance to identify neoplasia in patients with UC of any extent beyond the rectum. C Show 11 more As per ASCRS 2014 guidelines, obtain endoscopic surveillance in patients with long- standing UC. B Show 3 more Cervical cancer surveillance: obtain annual cervical cancer screening in female patients with IBD on immunosuppressive therapy. B Skin cancer surveillance: Obtain screening for melanoma in patients with IBD independent of the use of biologic therapy. B Obtain screening for non-melanoma squamous cell cancer in patients with IBD receiving immunomodulators (6-mercaptopurine or azathioprine), particularly > 50 years of age. B Clinical findings Patient demographics Symptoms White race Abdominal cramps Abdominal pain Past medical history Chronic diarrhea Defecation urgency Age < 30 Fatigue Autoimmune disorders Fever Diarrhea, often with blood or pus Inability to defecate despite urgency IBD Poorly localized abdominal pain Vital signs Rectal pain Weight loss Family history Rectal exam Ulcerative colitis Rectal blood Ocular exam Hematological findings Scleritis Anemia Lab findings blood eosinophils Inflammatory diarrhea Serological findings p-ANCA Studies https://web.pathway.md/diseases/recPfEbvwZ5o0OFe2 15/18 6/29/23, 3:46 AM Ulcerative colitis Pathway 2023 EARNEST In adult patients who developed chronic pouchitis after undergoing ileal pouch-anal anastomosis for ulcerative colitis, vedolizumab was superior to placebo with respect to modified Pouchitis Disease Activity Index-defined remission at week 14. Simon Travis et al. N Engl J Med. 2023 Mar 30. 2019 Fecal transplant for ulcerative colitis In patients with mild to moderately active ulcerative colitis, pooled donor fecal transplant was superior to autologous fecal transplant with respect to a steroid-free remission at 8 weeks. Costello SP et al. JAMA. 2019 Jan 15. References 1. Stephan C Bischoff, Palle Bager, Johanna Escher et al. ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr. 2023 Jan 13;42 3 352 379. Open 2. Rubin DT, Ananthakrishnan AN, Siegel CA et al. ACG Clinical Guideline: Ulcerative Colitis in Adults. Am J Gastroenterol. 2019 Mar;114 3 384 413. Open 3. Belinda De Simone, Justin Davies, Elie Chouillard et al. WSES AAST guidelines: management of inflammatory bowel disease in the emergency setting. World J Emerg Surg. 2021; 16 23. Open 4. Stephan C Bischoff, Johann Ockenga, Ahad Eshraghian et al. Practical guideline on obesity care in patients with gastrointestinal and liver diseases Joint ESPEN/UEG guideline. Clin Nutr. 2023 Apr 10;42 6 987 1024. Open 5. Ross H, Steele SR, Varma M et al. Practice parameters for the surgical treatment of ulcerative colitis. Dis Colon Rectum. 2014 Jan;57 1 5 22. Open 6. Sahil Khanna, Andrea Shin, Ciar n P Kelly. Management of Clostridium difficile Infection in Inflammatory Bowel Disease: Expert Review from the Clinical Practice Updates Committee of the AGA Institute. Clin Gastroenterol Hepatol. 2017 Feb;15 2 166 174. Open 7. Colleen R Kelly, Monika Fischer, Jessica R Allegretti et al. ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections. Am J Gastroenterol. 2021 Jun 1;116 6 1124 1147. Open 8. Francis A Farraye, Gil Y Melmed, Gary R Lichtenstein et al. ACG Clinical Guideline: Preventive Care in Inflammatory Bowel Disease. Am J Gastroenterol. 2017 Feb;112 2 241 258. Open 9. Mullish BH, Quraishi MN, Segal JP et al. The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications: joint British Society of Gastroenterology BSG and Healthcare Infection Society HIS guidelines. Gut. 2018 Nov;67 11 1920 1941. Open 10. Kornbluth A, Sachar DB, Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010 Mar;105 3 501 23. Open 11. Grace L Su, Cynthia W Ko, Premysl Bercik et al. AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders. Gastroenterology. 2020 Aug;159 2 697 705. Open https://web.pathway.md/diseases/recPfEbvwZ5o0OFe2 16/18 6/29/23, 3:46 AM Ulcerative colitis Pathway 12. Stefan D Holubar, Amy L Lightner, Vitaliy Poylin et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Ulcerative Colitis. Dis Colon Rectum. 2021 Jul 1;64 7 783 804. Open 13. Joseph D Feuerstein, Kim L Isaacs, Yecheskel Schneider et al. AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis. Gastroenterology. 2020 Apr;158 5 1450 1461. Open 14. Axel U Dignass, Christoph Gasche, Dominik Bettenworth et al. European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases. J Crohns Colitis. 2015 Mar;9 3 211 22. Open 15. Tim Raine, Stefanos Bonovas, Johan Burisch et al. ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment. J Crohns Colitis. 2022 Jan 28;16 1 2 17. Open 16. Expert Panel on Gastrointestinal Imaging: Angela D. Levy, MD, Peter S. Liu et al. ACR Appropriateness Criteria Anorectal Disease. ACR. 2021. Open 17. Siddharth Singh, Ashwin N Ananthakrishnan, Nghia H Nguyen et al. AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Ulcerative Colitis. Gastroenterology. 2023 Mar;164 3 344 372. Open 18. Conrad K, Roggenbuck D, Laass MW. Diagnosis and classification of ulcerative colitis. Autoimmun Rev. 2014 Apr-May;13 4 5 463 6. Open 19. Danese S, Fiocchi C. Ulcerative colitis. N Engl J Med. 2011 Nov 3;365 18 1713 25. Open 20. Ng SC, Shi HY, Hamidi N et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018 Dec 23;390 10114 2769 2778. Open 21. Gajendran M, Loganathan P, Jimenez G et al. A comprehensive review and update on ulcerative colitis. Dis Mon. 2019 Mar 2. pii: S0011 5029 19 30031 8. Open 22. Winther KV, Jess T, Langholz E et al. Survival and cause-specific mortality in ulcerative colitis: follow-up of a population-based cohort in Copenhagen County. Gastroenterology. 2003 Dec;125 6 1576 82. Open 23. Kathryn A. Myers, MD, EdM et al. Does This Patient Have Clubbing?. JAMA. 2001;286 3 341 347. Open 24. Feuerstein JD, Nguyen GC, Kupfer SS et al. American Gastroenterological Association Institute Guideline on Therapeutic Drug Monitoring in Inflammatory Bowel Disease. Gastroenterology. 2017 Sep;153 3 827 834. Open 25. Costello SP, Hughes PA, Waters O et al. Effect of Fecal Microbiota Transplantation on 8 Week Remission in Patients With Ulcerative Colitis: A Randomized Clinical Trial. JAMA. 2019 Jan 15;321 2 156 164. Open 26. James D. Lewis, M.D., M.S.C.E. et al. Use of the Non-invasive Components of the Mayo Score to Assess Clinical Response in Ulcerative Colitis. Inflamm Bowel Dis. 2008 Dec; 14 12 1660 1666. Open 27. Baldeep Singh Pabla, MD, MSCI and David Allen Schwartz et al. Assessing Severity of Disease in Patients with Ulcerative Colitis. Gastroenterol Clin North Am. 2020 Dec; 49 4 671 688. Open 28. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2 4947 1041 8. Open https://web.pathway.md/diseases/recPfEbvwZ5o0OFe2 17/18 6/29/23, 3:46 AM Ulcerative colitis Pathway 29. Anand Padmanabhan, Laura Connelly-Smith, Nicole Aqui et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue. J Clin Apher. 2019 Jun;34 3 171 354. Open 30. Lamb CA, Kennedy NA, Raine T et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019 Dec;68 Suppl 3):s1-s106. Open 31. Sanjay K Murthy, Joseph D Feuerstein, Geoffrey C Nguyen et al. AGA Clinical Practice Update on Endoscopic Surveillance and Management of Colorectal Dysplasia in Inflammatory Bowel Diseases: Expert Review. Gastroenterology. 2021 Sep;161 3 1043 1051.e4. Open https://web.pathway.md/diseases/recPfEbvwZ5o0OFe2 18/18