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Ulcerative Colitis

What is ulcerative colitis?

Ulcerative colitis is an inflammatory bowel disease in which the inner lining of the large intestine (colon or bowel) and rectum become inflamed. Inflammation usually begins in the rectum and lower (sigmoid) intestine and spreads upward to the entire colon. Ulcerative colitis rarely affects the small intestine except for the lower section, the ileum.

The inflammation causes diarrhea, or frequent emptying of the colon. As cells on the surface of the lining of the colon die and slough off, ulcers (open sores) form, causing pus, mucus, and bleeding.

What causes ulcerative colitis?

Although many theories about what causes ulcerative colitis exist, none has been proven. The cause of ulcerative colitis is unknown, and currently there is no cure, except through surgical removal of the colon. A theory suggests that some agent, possibly a virus or an atypical bacterium, interacts with the body's immune system to trigger an inflammatory reaction in the intestinal wall.

Although much scientific evidence shows that people with ulcerative colitis have abnormalities of the immune system, physicians do not know whether these abnormalities are a cause or result of the disease.

There is little proof that ulcerative colitis is caused by emotional distress or sensitivity to certain foods or food products, or is the result of an unhappy childhood.

Who is affected by ulcerative colitis?

Although children and older people sometimes develop ulcerative colitis, it most often affects people ages 15 to 40. It affects males and females equally and appears to run in some families.

Why is ulcerative colitis a concern?

Ulcerative colitis requires long-term medical care. There may be remissions - periods when the symptoms go away - that last for months or even years. However, usually symptoms eventually return.

Only in rare cases, when complications occur, is the disease fatal. If only the rectum and lower colon are involved, the risk of cancer is not higher than normal. However, the risk of colon cancer is greater than normal in children with widespread ulcerative colitis.

What are the symptoms of ulcerative colitis?

The following are the most common symptoms for ulcerative colitis. However, each child may experience symptoms differently. Symptoms may include:

Sometimes children also experience:

The symptoms of ulcerative colitis may resemble other conditions or medical problems. Consult your child's physician for a diagnosis.

How is ulcerative colitis diagnosed?

A thorough physical examination, including blood tests to determine whether an anemic condition exists, or if the white blood cell count is elevated (a sign of inflammation), is part of the diagnostic process. Symptoms that suggest ulcerative colitis may also be evaluated with the following procedures:

Illustration demonstrating a colonoscopy, part 1
Click Image to Enlarge
Illustration demonstrating a colonoscopy, part 2

Treatment for ulcerative colitis:

Specific treatment will be determined by your child's physician based on the following:

While there is no special diet for ulcerative colitis, children may be able to control mild symptoms simply by avoiding foods that seem to upset their intestines.

When treatment is necessary, it must be tailored for each case, because what may help one patient may not help another. Children are also given needed emotional and psychological support. Treatment may include the following:

There are several surgical options:

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