Editor's note:

In response to the Belt and Road Initiative, and with the aim of sharing expertise and addressing shared health challenges, our hospital has launched the Overseas Promotion Program for New Medical Technologies. If you are interested in any of the medical technologies covered under this program, please feel free to contact the International Cooperation Office at faowch@163.com.

Construction of a Novel Diagnostic and Therapeutic System for Acute Severe Ulcerative Colitis Based on Early Precise Assessment and Stratified Intervention

Technical Overview:

Acute Severe Ulcerative Colitis (ASUC) is a life-threatening exacerbation of ulcerative colitis (UC), characterized by bloody diarrhea, systemic toxicity, and rapid clinical deterioration. Globally, approximately 15% of UC patients develop ASUC, and 20%–30% of these patients ultimately require emergent colectomy despite intensive medical therapy. Colectomy in ASUC not only entails significant perioperative risks but also leads to impaired quality of life, substantial healthcare costs, and long-term psychological burden.

These challenges emphasize the critical importance of improving early risk stratification and adopting evidence-based approaches to guide clinical decisions. However, traditional diagnostic criteria, such as the Truelove-Witts index, are primarily based on clinical symptoms and serum inflammatory markers, lacking objective assessment of intestinal lesions. Additionally, current international guidelines recommend against total colonoscopy at the early stage of ASUC due to concerns about inducing toxic megacolon, thus limiting evaluation to sigmoidoscopy. This limited endoscopic view often fails to capture the full extent of inflammation and mucosal damage, compromising disease staging and therapeutic decision-making.

Clinical Application and Innovation:

To overcome these limitations, we have developed a novel diagnostic and therapeutic framework that integrates early full colonoscopy, clinical scoring, and laboratory biomarkers to construct a comprehensive ASUC stratification model. This model supports a tailored “stratified intervention algorithm” that enables timely, individualized escalation or de-escalation of treatment according to disease severity.

In my more than 20 years clinical practice, the implementation of this system in all ASUC patients resulted in a 100% success rate with internal medical therapy and no colectomy requirement. This represents a paradigm shift from empirical, reactive treatment to proactive, precision-guided care.

Therapeutic Value and International Relevance:

ASUC imposes a significant economic and healthcare burden worldwide, especially in low-resource settings with limited access to surgical care. Our strategy provides a low-cost, reproducible, and clinically scalable solution that can be readily adopted in diverse healthcare environments. Furthermore, a prospective study is currently underway to evaluate not only the clinical efficacy of this approach but also the underlying molecular mechanisms that may reveal novel therapeutic targets. This system aligns with the global push toward precision medicine and evidence-based care and is particularly valuable for “Belt and Road” countries facing increasing UC prevalence. It holds great potential for international collaboration, clinical implementation, and scientific advancement.