Article Text

Download PDFPDF
Case report
Change in paradigm: impact of an IBD medical home on the outpatient management of acute severe ulcerative colitis
  1. Vernissia Tam1,
  2. Marc Schwartz2,
  3. Jennifer Holder-Murray3 and
  4. Javier Salgado Pogacnik3
  1. 1 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
  2. 2 Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
  3. 3 Department of Surgery, Division of Colon and Rectal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
  1. Correspondence to Dr Javier Salgado Pogacnik; salgadojavier{at}


A 72-year-old man presents with acute severe ulcerative colitis (ASUC), initially partially responsive to intravenous steroids and infliximab over a 3-day hospital stay. Following discharge and over the course of 15 days, his care was coordinated by the inflammatory bowel disease medical home team, who conducted clinical laboratory assessments and two outpatient flexible sigmoidoscopies to evaluate endoluminal disease activity and treatment response prior to proceeding with a laparoscopic total abdominal colectomy and creation of end ileostomy following medical failure. He was admitted to the hospital for a total of only 7 days, which included attempted medical management of ASUC, surgery and postoperative recovery.

  • Ulcerative colitis
  • Health economics
  • Medical management
  • Gastrointestinal surgery

Statistics from


  • Contributors VT prepared the draft of the manuscript. VT, MS, JH-M and JSP revised the manuscript. All authors approved of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.