Ulcerative Colitis

Ulcerative [UHL-ser-uh-tiv] colitis [koh-LIE-tis] is a type of inflammatory bowel disease. It is a disease that causes inflammation (swelling) and sores (ulcers) in the lining of the large intestine and rectum. The condition usually starts between the ages of 15 and 30 years, but can happen at any age. It often runs in families.

Ulcerative colitis is a long-lasting (chronic) condition. It usually begins slowly and gets worse over time. Most people have periods when there are no symptoms (remission). The goal of treatment is to prevent symptoms and stay in remission.

Symptoms may include:

• Abdominal (belly) pain
• Bloody diarrhea
• Low energy
• Weight loss
• Loss of appetite
• Nausea
• Dehydration
• Rectal bleeding
• Joint pain
• Severe tiredness
• Slow or no growth in children

See your healthcare provider if your child has:

• Any of the signs or symptoms of ulcerative colitis
• Ongoing diarrhea that does not get better with over-the-counter medicine
• Unexplained fever of 101  F (38  C) or higher that lasts more than a few days

Doctors aren’t sure what causes the disease, but most agree that it is NOT caused by sensitivity to certain foods or by stress. However, these factors may trigger symptoms in a child who already has the disease.

We do know that children with ulcerative colitis have abnormal immune system reactions that kill healthy cells in the lining of the colon. Inflammation and ulcers then form around the dead cells.

It isn’t clear what causes this abnormal reaction, but your child may be more at risk based on their:

• Family history. They’re more likely to have ulcerative colitis if a close family member has it.
• Ethnicity. They’re more likely to develop this disease if they’re of Eastern European (Ashkenazi) Jewish descent.
• Age. Ulcerative colitis can start at any age, but usually starts between ages 15 and 30.
• Environment. Ulcerative colitis is more common among people who live in urban areas and industrialized countries.

Your doctor may recommend one or more tests:

• A colonoscopy is the best way to tell if your child has ulcerative colitis. During a colonoscopy, a thin, flexible tube with a camera at the end (a colonoscope) is used to look inside the colon. There, the doctor can see inflammation or bleeding, and can take tissue samples (biopsies) to analyze in a laboratory.
• Blood tests are used to look for signs of anemia or infection in the rectum or colon.
• A stool (poop) sample can also show signs of bleeding or infection in the colon or rectum.
• A barium enema allows the doctor to see your child’s entire colon with an x-ray. The inside of their colon is coated with a chalky liquid that contains barium. The barium makes it easier to see any problems with your child’s colon. 

Ulcerative colitis is generally treated with medicines, surgery, or both.

• Medicines. Medicines cannot cure ulcerative colitis. The goal of treatment is to prevent symptoms and improve quality of life. The type of medicine will depend on the symptoms your child has. Most people with ulcerative colitis need treatment with medicine throughout the rest of their lives.
• Surgery. Surgical removal of the diseased part of the large intestine or rectum can take away the need for medicine. Your child’s treatment will depend on the severity of their condition and symptoms.
• Nutrition. Good nutrition is an important part of managing ulcerative colitis. Your healthcare provider may recommend a specific diet based on your child’s symptoms. They may recommend diet changes such as:
  • Avoiding carbonated drinks.
  • Avoiding popcorn, nuts, and other high-fiber foods while your child has symptoms.
  • Eating smaller meals.

There are no known ways to prevent ulcerative colitis, but there are steps you can take to prevent or reduce your child’s symptoms, such as:

• Avoiding certain foods. Dairy products, beans, popcorn, broccoli, cabbage, raw fruits, soda pop, chocolate, and spicy foods can make symptoms worse.
• Providing more foods high in fiber.
• Eating smaller, more frequent meals.
• Drinking plenty of water.
• Limiting stress.
• Exercising.

Crohn’s & Colitis Foundation: Crohn’s Disease & Ulcerative Colitis: A Guide for Parents

KidsHealth: Inflammatory Bowel Disease

MedlinePlus: Ulcerative Colitis

National Institute of Diabetes and Digestive and Kidney Diseases: Ulcerative Colitis

Ulcerative colitis is one type of inflammatory bowel disease. It causes inflammation (swelling) and sores in the lining of the large intestine and rectum. The condition usually starts between the ages of 15 and 30 years, but can happen at any age.

Ulcerative colitis is a long-lasting condition, but your healthcare provider can help your child or teen manage the symptoms.