Ulcerative Colitis

Ulcerative colitis is a type of inflammatory bowel disease in which the inner lining of the large intestine (colon) and rectum become inflamed. Inflammation usually begins in the rectum and lower large intestine and spreads upward, potentially involving the entire colon. Ulcerative colitis causes diarrhea and frequent emptying of the colon. As cells on the surface of the colon die and fall off, ulcers (open sores) form, leading to pus, mucus, and bleeding.

Ulcerative colitis may occur at any age but is most common in older children and young adults and may run in some families. Although there is no cure, the right treatment plan can minimize or eliminate ulcerative colitis symptoms with medication, lifestyle changes, and, in some cases, surgery. The condition also can go into periods of remission.

Ulcerative colitis affects all patients differently, but the most common symptom is frequent, bloody diarrhea.

Other common ulcerative colitis symptoms include:

• Abdominal pain
• Fatigue
• Weight loss
• Loss of appetite
• Rectal bleeding
• Loss of body fluids and nutrients
• Anemia caused by severe bleeding

Some patients may also experience:

• Skin lesions
• Joint pain
• Eye inflammation
• Liver disorders
• Osteoporosis
• Rashes
• Kidney stones

Experts do not yet know the cause of ulcerative colitis, but it’s an area of active research. We believe that both genes and environment play a role. We also know that the immune system is involved, which is why ulcerative colitis treatment often involves medication to reduce its activity.

Diagnosing ulcerative colitis begins with an examination and a detailed medical history. Your child’s clinician will rule out other possible causes and may recommend one or more of the following tests:

• Blood tests
• Stool sample tests
• Endoscopy
• Colonoscopy
• Video capsule endoscopy
• MR enterography
• Biopsy
• Imaging studies

Once you have an accurate diagnosis, the goal is to get your child on the road to proper care and management of pediatric ulcerative colitis — and, most importantly, to start feeling better as soon as possible.

With consistent ulcerative colitis treatment and a good understanding of the condition, the vast majority of children with the condition go on to live full and active lives. Depending on the severity of symptoms, treating ulcerative colitis often requires a combination of approaches:

Medication

Drug therapy can reduce inflammation and control symptoms. Ulcerative colitis medications may include:

• Anti-inflammatory drugs, such as steroids, to bring the disease under control
• Immune system suppressants that can reduce swelling
• Antibiotics to treat related complications, such as abscesses or fistulas
• Antiulcer/H2 blockers (acid-reducing medications) to treat related ulcers and irritation

At the Boston Children’s Inflammatory Bowel Disease Center, our team believes that, with proper management, all children and teens with ulcerative colitis can live comfortably. We partner with you and your child to effectively manage IBD and provide support through all life stages, from school and relationships to work.