Abstract
Acute severe colitis fortunately occurs in only a minority of patients with inflammatory bowel disease (IBD), but its onset heralds a difficult disease course. With the institution of the ‘Oxford regimen’ several decades ago, the mortality of acute severe ulcerative colitis (UC) has fallen to 2% or less in high-volume centres [1–3]. The two main pillars of this approach were administration of intravenous corticosteroids and a willingness to proceed with colectomy if the patient was not clinically improving within 5–10 days of admission.
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