]> 2026-07-31T07:51:21+00:00 WBR1116 0 en Switch to oral glucocorticoids Switch to oral steroid therapy is done gradually in patients with fulminant colitis showing clinical response to IV steroids over a period of 10 days. Continue intravenous glucocorticoids Discontinue steroids and start oral 5-ASA therapy Switch to intravenous infliximab Perform a complete diagnostic colonscopy Emergency Room A 40 year old male comes to the emergency department with complaints of fever, generalized abdominal pain and bloody stools. He was diagnosed with ulcerative colitis 2 years back and has been on and off sulfasalazine treatment. His flare up started 2 days ago and quickly progressed to severe abdominal pain and multiple bloody stools. On examination his vitals are pulse: 104/min, BP: 140/80 mmHg and temperature 38 degree Celsius. Abdominal examination reveals hypoactive bowel sounds and generalized distension with rebound tenderness. Abdominal X-ray shows colonic dilatation of > 6cm with some air fluid levels. There is no pnueumoperitoneum. Initial lab evaluation shows Hb: 10 g/dl, WBC: 18,500/mm3, platelets: 330,000/mm3, blood glucose: 100 mg/dl, serum creatinine: 1 mg/dl and potassium: 3 mEq/L. Stool studies are negative for infectious etiology. Patient is started on intravenous fluids, intravenous steroids, and broad spectrum antibiotics. On the 3rd day of hospitalization his symptoms began to improve. Which of the following would the most appropriate next step in the management of this patient? B Gastrointestinal 2020-10-28T02:40:02Z 2459150.6111343 WBR1116