What is ulcerative colitis?

Ulcerative colitis in children: Overview

Ulcerative colitis is an inflammatory bowel disease. The large intestine (colon) gets inflamed, and ulcers form in the colon. These ulcers can bleed.

People have "attacks" of ulcerative colitis. Attacks can come and go. They can cause painful belly cramps and bloody diarrhea.

Bad attacks are often treated in a hospital. There your child can get medicines, fluid, and nutrition through a tube in a vein, called an I.V. This lets the digestive system rest and recover.

If the medicines don't work well, your child may need surgery to remove the colon.

Learning good self-care can help your child reduce symptoms and manage ulcerative colitis.

Teens can be especially frustrated by this disease. Attacks may leave them feeling more dependent on their parents than they want to be. They may feel different from their friends. Counseling may help teens who are having a hard time coping with the disease.

Ulcerative colitis

Ulcerative colitis makes swelling, inflammation, and sores in the lining of the large intestine (colon) and causes diarrhea, belly pain, and bleeding from the rectum. It's a lifelong condition, but in most people the symptoms come and go.

Medicines can stop or reduce symptoms and prevent flare-ups. If the disease is severe, you may need surgery to remove the colon.

What happens when you have ulcerative colitis?

Ulcerative colitis may be mild, moderate, or severe.

Most people have periods of remission (when the condition is not active) that may last months or years. During these periods, people may sometimes have flare-ups with moderate symptoms. Some people have symptoms all the time.

Children may have the same symptoms that adults have. Also, children with the disease may grow more slowly than normal and go through puberty later than expected.

What are the symptoms of ulcerative colitis?

The main symptoms of ulcerative colitis are belly pain or cramps, diarrhea, and bleeding from the rectum. In severe cases, people may have diarrhea 10 to 20 times a day. Some people also may have a fever, not feel hungry, and lose weight. In most people, the symptoms come and go.

How is ulcerative colitis treated?

Medicines can help reduce your symptoms and help you avoid new flare-ups. If you have severe symptoms and medicines don't help, you may need surgery to remove your colon. This cures ulcerative colitis.

How is ulcerative colitis diagnosed?

To diagnose ulcerative colitis, a doctor will ask about your symptoms, do a physical exam, and do a number of tests. Testing can help rule out other problems that can cause similar symptoms, such as Crohn's disease and irritable bowel syndrome.

Tests that may be done include:

  • Colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
  • Blood tests to check for infection or inflammation.
  • Stool sample testing to look for blood, infection, and white blood cells.

How are medicines used to treat ulcerative colitis?

Medicines are the main treatment for ulcerative colitis. They are used to control inflammation in the intestines and then keep it from coming back. Your doctor will talk to you about your choices.

For mild or moderate cases of the disease when there is little risk of needing surgery, most people use aminosalicylates or steroid medicines. These can be taken as a pill, suppository, rectal foam, or enema.

For moderate or severe cases of the disease when there is a high risk of needing surgery, you will need medicines (such as biologics) to prevent inflammation. These are given intravenously (I.V.) or as a shot. Many people also need aminosalicylates, steroid medicines, or other medicines to calm down the immune system.

If you are pregnant or planning to become pregnant, talk to your doctor about which medicines are safest.

Who can diagnose and treat ulcerative colitis?

Health professionals who can diagnose ulcerative colitis include:

  • Family medicine physicians.
  • Internists.
  • Gastroenterologists.

For the treatment and management of ulcerative colitis, you are likely to be referred to a gastroenterologist.

To be evaluated for surgery, you may be referred to a:

  • Surgeon.
  • Colon and rectal surgeon.

How can you care for your child's ulcerative colitis?

  • Call your doctor if you think your child is having a problem with a medicine.
  • Do not give your child anti-inflammatory medicines unless the doctor says it is okay. These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). They may make symptoms worse.
  • Talk to your doctor before you give your child any other medicines or herbal products.
  • Make sure your child eats enough protein and drinks plenty of fluids. During a flare-up, avoid foods that make your child's symptoms worse. This may include foods that are high in fiber or high in fat. It may also include foods and drinks that have lactose, like dairy products.
  • Talk to a dietitian to make sure your child is getting the nutrition, including vitamins and minerals, that they need.

Deciding Between Surgery and Medicines for Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is a disease that causes parts of the digestive tract to become inflamed and form deep sores. These sores are called ulcers. The disease can affect the colon and the rectum. It can cause belly pain and diarrhea.

In many cases, medicines may ease inflammation and control symptoms. But sometimes they don't work.

This information will help you decide between having surgery and using medicines.

What are key points about this decision?

  • Most people who have mild colitis can control their symptoms with medicine. In most cases, surgery is not done when the disease is mild.
  • The only cure for ulcerative colitis is surgery to remove the colon and the lining of the rectum. After the most common type of surgery, you will still be able to have bowel movements. After the less common type of surgery, you will wear an ostomy bag to remove body waste.
  • Your risk of colon cancer may start to go up after 8 to 10 years. Your risk is highest if a lot of your colon is involved. Surgery almost completely removes the risk of colon cancer.
  • In most cases, surgery works well. But it does have risks. Your small intestine could get blocked. Or you might leak stool.

Why might you choose surgery?

  • You have severe symptoms that medicines do not control.
  • Surgery cures ulcerative colitis.
  • You are worried about colon cancer. Surgery almost completely removes the risk of colon cancer. And it can cure it if the cancer has not spread beyond the colon.
  • You don't want to take medicine for the rest of your life.
  • You are having serious side effects from your medicines.

Why might you choose medicine?

  • Your symptoms don't bother you very often or very much.
  • You don't mind trying different types of medicines until you find one that works for you.
  • You understand the side effects of the medicines. You feel that you can deal with them.
  • You worry about the risks of surgery.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.

Ulcerative Colitis

Colon with ulcerative colitis

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that causes inflammation and sores (ulcers) in the inner lining of the colon and rectum. It causes diarrhea, abdominal pain, and rectal bleeding.

What causes ulcerative colitis?

Experts aren't sure what causes ulcerative colitis. It might be caused by the immune system overreacting to normal bacteria in the digestive tract. Or other kinds of bacteria and viruses may cause it. You are more likely to get it if other people in your family have it.

What other health problems can happen when you have ulcerative colitis?

Problems from ulcerative colitis can include:

  • Narrowed areas of the intestine (strictures). They can make it hard to pass stools.
  • Increased risk of cancer of the colon and rectum. Your risk may start to go up after 8 to 10 years. Your risk is highest if a lot of your colon is involved.
  • Problems outside the digestive tract. These include joint pain, skin problems, eye problems, or liver disease.
  • The colon swelling to many times its normal size. This is called toxic megacolon. It's rare, but it needs treatment right away.
  • Other rare problems, such as scarring of the bile ducts and the pancreas.
  • Increased risk of melanoma, a serious type of skin cancer. Your doctor may recommend regular screening by a dermatologist.

Irritable bowel syndrome

Some people who have ulcerative colitis also have irritable bowel syndrome (IBS). It isn't as serious as ulcerative colitis. IBS causes belly pain along with diarrhea or constipation.

What is ulcerative colitis?

Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine, or colon. It usually affects the lower section and the rectum. But it can affect the entire colon. In general, the more of the colon that's affected, the worse the symptoms will be.

Ulcerative colitis in children: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child passes out (loses consciousness).
  • Your child's stools are maroon or very bloody.

Call your doctor now or seek immediate medical care if:

  • Your child has symptoms of dehydration, such as:
    • Dry eyes and a dry mouth.
    • Passing only a little urine.
    • Feeling thirstier than usual.
  • Your child has new or worse belly pain.
  • Your child has a fever.
  • Your child has new or worse nausea or vomiting.
  • Your child has new or more blood in their stools.
  • Your child cannot pass stools or gas.
  • Your child has pus draining from the area around the anus or pain and swelling in the anal area.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

  • Your child has new or worse symptoms, such as diarrhea that gets worse.
  • Your child loses weight, or doesn't gain weight.
  • You or your child is struggling to cope with ulcerative colitis.
  • Your child is not getting better as expected.

©2011-2024 Healthwise, Incorporated

The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.