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Inflammatory bowel disease III
PWE-261 Have you heard of the Truelove and Witts criteria? acute severe ulcerative colitis management by FY1 doctors
  1. V Chhaya,
  2. Y Squire,
  3. N Siva,
  4. A Poullis
  1. Department of Gastroenterology, St Georges Hospital, London, UK

Abstract

Introduction Acute severe ulcerative colitis (UC) is a serious illness that requires prompt hospitalisation and is associated with significant morbidity. It requires intensive monitoring, specialist intervention and a multidisciplinary approach throughout the duration of the illness with timely and appropriate medical and surgical interventions to avoid complications. Our aim was to evaluate the Foundation Year 1 (FY1) doctor's knowledge and understanding of this potentially life threatening emergency.

Methods We approached FY1 doctors with an example case of acute severe UC and a questionnaire asking several questions regarding the diagnosis and management of acute severe UC 5 months into their training in 2011.

Results 48 FY1 doctors completed the questionnaire during a medical teaching session. Only 25% had heard of the Truelove and Witts criteria as a tool for assessing the severity of UC. When asked regarding the criteria, 77.08% recognised stool frequency as one, 72.91% heart rate, 62.5% temperature, 41.67% haemoglobin and 35.42% erythrocyte sedimentation rate (ESR) as part of it. 58.33% of those asked diagnosed the example case as an acute severe UC, however only 43.75% stated that they would request daily abdominal x-rays as part of their management plans. 62.5% of those asked knew intravenous corticosteroid therapy was mainstay of the initial treatment. 72.92% answered correctly regarding the use of thromboprophylaxis as standard therapy in the management of the condition and 79.17% said they would regularly check the serum potassium level during the course of the presentation.

Conclusion This study highlights the lack of knowledge and understanding of the diagnosis and management of acute severe UC by the FY1s. We would recommend a more structured approach to teaching regarding the condition at all levels of training during planned sessions. Protocols for admission and management of acute UC and local acute medicine hospital guidelines may aid education and bridge gaps in knowledge.

Competing interests None declared.

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