The primary treatment for severe ulcerative colitis remains intravenous hormones. Usually methylprednisolone 60mg/24h or hydrocortisone 100mg is given intravenously
four times a day. In the absence of severe gastrointestinal bleeding, subcutaneous heparin should be given prophylactically to avoid deep vein thrombosis. The effectiveness of intravenous hormones should be assessed on day 3 after administration. At this time, the option of surgery should be discussed in patients who have had poor results with intravenous hormones. For patients who have not used azathioprine and do not wish to undergo surgery, second-line drug therapy, including infliximab and cyclosporine, may be used. Surgical resection of the colon is recommended after day 7 of the above drug regimen if there is still no clinical remission. Further prolongation of drug therapy will not benefit the patient, but will increase the complications of the inevitable surgery.