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Ulcerative Colitis

Medically reviewed by: J. Fernando del Rosario, MD

What Is Ulcerative Colitis?

Ulcerative colitis is a condition that causes the inner lining of the large intestine (colon) to get red and swollen with sores called ulcers. It's a chronic condition, which means it lasts a long time or constantly comes and goes.

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that happens only in the colon.

What Are the Signs & Symptoms of Ulcerative Colitis?

The most common symptoms of ulcerative colitis are cramping belly pain and diarrhea. Other symptoms include:

  • blood in the toilet, on toilet paper, or in the stool (poop)
  • urgent need to poop
  • a fever
  • low energy
  • weight loss

Ulcerative coliits can cause other problems, such as rashes, eye problems, joint pain and arthritis, and liver disease. Kids with ulcerative colitis may not grow well as well as other kids their age and puberty may happen later than normal.

What Causes Ulcerative Colitis?

The exact cause of ulcerative colitis is not clear. It is probably a combination of genetics, the immune system, and something in the environment that causes inflammation in the gastrointestinal tract. Diet and stress may make symptoms worse, but probably don't cause ulcerative colitis.

Who Gets Ulcerative Colitis?

Ulcerative colitis tends to run in families. But not everyone with ulcerative colitis has a family history of BD. Ulcerative colitis can happen at any age, but is usually diagnosed in teens and young adults.

How Is Ulcerative Colitis Diagnosed?

Ulcerative colitis is diagnosed with a combination of blood tests, stool tests, and X-rays. Medical imaging tests, such as CT scans and MRIs, might be done too.

The doctor will check the stool for blood, and might look at the colon with an instrument called an endoscope, a long, thin tube attached to a TV monitor. In this procedure, called a colonoscopy, the tube is inserted through the anus to let the doctor see inflammation, bleeding, or ulcers on the wall of the colon. During the procedure, the doctor might do a biopsy (taking small tissue samples for further testing).

How Is Ulcerative Colitis Treated?

Ulcerative colitis is treated with medicines and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems, and avoid flare-ups.

The doctor may recommend:

  • anti-inflammatory drugs to decrease the inflammation
  • immunosuppressive agents to prevent the immune system from causing further inflammation
  • biologic agents to block proteins that cause inflammation

Because some medicines make it harder to fight infections, it's important that your child be tested for tuberculosis and have all the recommended vaccines before starting treatment.

Surgery may be necessary if:

  • the bowel develops a hole
  • the bowel widens and swells up (called toxic megacolon
  • the bleeding can't be stopped
  • symptoms don't respond to treatment

What Else Should I Know About Ulcerative Colitis?

Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for people with ulcerative colitis to get the calories and nutrients the body needs.

Kids and teens with ulcerative colitis should eat a variety of foods, get plenty of fluids, and learn to avoid foods that make symptoms worse. Some may need supplements, like calcium or vitamin D. Kids who are not growing well may need additional nutrition support.

Kids and teens with ulcerative colitis can feel different and might not be able to do the things their friends can do, especially during flare-ups. Some struggle with a poor self-image, depression, or anxiety. They may not take their medicine or follow their diet. It's important to talk to your health care professional if you're concerned about your child's mood, behavior, or school performance.

Parents can help teens with ulcerative colitis take on more responsibility for their health as they get older.

Medically reviewed by: J. Fernando del Rosario, MD
Date reviewed: October 2017