A 56 years old female with history go bleeding PR for last 2 years.
She was diagnosed to have ulcerative pan-colitis.
Steroid dependent, put on Azathioprine - persistent symptoms.
Started on Infliximab - initially responded to treatment for 6 months. Now recurrent symptoms (see colonoscopy picture)
Next step?
Vedolizumab
Colectomy
Do colonoscopic biopsy - rule out CMV/C. Difficile
Fecal microbiota transplant
