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Immune checkpoint inhibitor (ICI)–related colitis is a common immune-related adverse event (irAE), typically presenting with diarrhea, cramping, and sometimes blood or mucus. Grade 3 toxicity (≥7 stools/day over baseline or severe symptoms) warrants holding the ICI and initiating high-dose corticosteroids (e.g., methylprednisolone 1–2 mg/kg/day IV or equivalent oral dosing if stable). Infectious etiologies (C. difficile, stool cultures) should be ruled out but therapy should not be unduly delayed in a clinically consistent scenario. If no improvement within 48–72 hours, escalation to infliximab or vedolizumab is recommended, with careful evaluation for perforation/toxic megacolon. Option A is inadequate for grade ≥2 colitis. Permanent discontinuation (Option C) is considered for life-threatening or steroid-refractory events; budesonide targets mild ileocolonic disease and is insufficient here. Octreotide (Option D) is not standard for ICI colitis. Patient education on symptom recognition, early reporting, hydration, and a stepwise steroid taper over at least 4–6 weeks to prevent rebound symptoms is integral to supportive care.