监测
应密切监测治疗效果及其并发症。
长期患有UC的患者随着疾病的发展异型增生的风险增加。 大肠癌的风险增加跟患者病程加长和广泛、严重的结肠炎，有结肠直肠癌家族史，发病年龄低，存在反流性回肠炎，以及原发性硬化性胆管炎的个人史有关。 UC患者发病开始8-10年后应该接受结肠镜检查。 [ 
] 监测的时间间隔取决于患者的危险因素不同而不同。 患者有高危因素（狭窄或在过去的5年之内检测到异型增生，原发性硬化性胆管炎，炎症广泛的重症活动性结肠炎，有50岁以内一级亲属患大肠癌的家族史）每1年应安排他们做结肠镜检查； 患者中度风险因素（炎症广泛的轻度至中度活动性结肠炎，炎症后息肉，有50岁以上一级亲属患大肠癌的家族史）应该每2-3年接受结肠镜检查。 所有其他患者应该每5年进行结肠镜检查。[109] British guidelines have recently been amended and now recommend less frequent surveillance in those with low-risk disease.[110]
泛结肠亚甲基蓝或靛蓝胭脂红色素内镜检查应在结肠镜检查时进行，目的用于可见病变以确定活检目标。
If sufficient expertise in chromoendoscopy is not available, biopsy specimens of the colon in patients with documented pancolitis should be obtained in all four quadrants every 10 cm from the caecum to the rectum,[109] to obtain a minimum of 32 biopsy samples. Diagnosis of dysplasia should be confirmed by a second gastrointestinal pathologist. The management of dysplastic polypoid lesions is evolving.
目前的专家共识指南推荐，在完全切除内镜下可切除息肉状和非息肉状异型增生病变组织后，应进行结肠镜检查监测，而非实施结肠切除术。[111] 对于有不可见低级别或高级别异型增生的患者，推荐转诊至擅长通过采用配有高清内镜的色素内镜检查进行肠易激综合征 (IBD) 监测和图像增强检查的内镜专科医师，以更好地指导有关结肠镜检查监测或结肠切除术的后续决定。[111] 如果发现结肠的同一部位有可见的异型增生病变，并且该病变可在内镜下切除，则可以继续对这些患者进行监测。不过，如果未发现异型增生病变，则在与患者讨论结肠镜检查监测和结肠切除术的风险和获益之后，应制定个体化的管理方案。[111]
当病情急性加重时，应首先排除是否有伴随或潜在感染。
Patients should be monitored and educated regarding the risk of osteoporosis. All patients should receive education on the importance of lifestyle changes (e.g., engaging in regular weight-bearing exercise, stopping smoking, avoiding excessive alcohol intake), as well as vitamin D and calcium supplementation. Dual energy x-ray absorptiometry (DXA) scans should be selectively ordered based on a thorough risk-factor assessment. In patients found to be osteoporotic or to have a low-trauma fracture, screening for other causes of low bone density should be performed through a full blood count (FBC), total serum alkaline phosphatase level, calcium level, creatinine level, 25-(OH) vitamin D level, protein electrophoresis, and testosterone level (in males). Corticosteroid dosing in inflammatory bowel disease should be kept to a minimum, and other immunomodulatory agents should be considered to help withdraw patients from corticosteroids once corticosteroid dependence becomes evident. Vitamin D and calcium supplementation should be given to those deemed to be at high risk for osteoporosis or with confirmed osteoporosis. Younger men and premenopausal women require 1000 mg/day of elemental calcium, whereas men and women >50 years of age require up to 1500 mg/day. Vitamin D 400 to 800 IU/day is usually an adequate replacement dose in healthy people; it can be obtained from many multivitamin preparations. Bisphosphonates therapy is approved for the prevention and treatment of osteoporosis in patients with known osteoporosis, patients with atraumatic fractures, and patients who cannot withdraw from corticosteroids after 3 months of use.[112]
原发性硬化性胆管炎应以 6 到 12 个月为周期进行肝功能检查。
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