ROSH Gastrointestinal Practice Exam

If a patient with ulcerative colitis is treated with antibiotics, corticosteroids, and a biologic, which complication are they at risk for?

1. Colon cancer

2. Pancreatitis

3. Peptic ulcer

4. Toxic megacolon

The correct answer is: Toxic megacolon

Patients with ulcerative colitis are at risk for various complications, particularly when undergoing treatment with specific medications such as antibiotics, corticosteroids, and biologics. Among these, toxic megacolon is a significant concern. Toxic megacolon is a severe condition characterized by extreme dilation of the colon, which can occur in patients with ulcerative colitis, especially during active disease phases. The use of corticosteroids and biologics can suppress the immune response, leading to an exacerbation of inflammation or allowing for opportunistic infections, both of which increase the risk of developing this complication. Patients on such aggressive therapy may also experience a disruption in normal bowel function, further contributing to the risk of toxic megacolon. This condition can lead to life-threatening situations, making timely recognition and appropriate management crucial for these patients. The other potential complications listed, such as colon cancer, pancreatitis, and peptic ulcers, do not have the same direct association with the combination of treatments mentioned or are not immediate risks associated with the acute disease state of ulcerative colitis. While colon cancer is a long-term risk for patients with ulcerative colitis due to chronic inflammation, it does not directly relate to the concurrent use of antibiotics, corticosteroids, and biolog