Pediatric ulcerative colitis (UC)

What is pediatric ulcerative colitis (UC)?

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD), along with Crohn’s disease. UC causes tiny sores in the large intestine lining, which bleed and produce mucus and pus.

Ulcerative colitis is a chronic (reoccurring) condition. The symptoms and their severity can vary — often, children will experience periods of remission where their symptoms are gone.

UC often begins slowly, but eventually, becomes more severe.

What are the signs and symptoms of pediatric ulcerative colitis (UC)?

• Abdominal pain or cramping

• Anemia

• Bloody stools

• Diarrhea with blood or pus

• Fatigue

• Fecal incontinence

• Fever

• Intense cramping

• Joint pain

• Skin rash

• Sudden urges to use the bathroom

Symptoms vary along with the severity of the disorder.

Problems related to UC extend beyond the GI tract, including:

• Ophthalmic conditions

• Joint pain

• Hepatobiliary disease (of the liver, gall bladder and bile ducts)

What are the causes of pediatric ulcerative colitis (UC)?

Experts are not sure what causes ulcerative colitis. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract. 

Ulcerative colitis is most likely to develop in children and young adults between the ages of 15 to 25; however, it can occur at any age. Having a family member with inflammatory bowel disease also increases the likelihood of getting UC.

How is pediatric ulcerative colitis (UC) treated?

Medical treatment

Medical treatment aims to contain and control intestinal inflammation, limit extra-intestinal involvement and make it possible for patients to lead as active and normal a life as possible.

Outpatient treatment includes the use of anti-inflammatory therapy. Corticosteroids are effective in subduing acute bouts of inflammation, but long-term steroid treatment is not advised due to its harmful side effects.

Conoloscopy

A pediatric colonoscopy includes a long, flexible, lighted tube (endoscope) allowing a gastroenterologist to examine a child's large and small bowel.

Surgery (proctocolectomy)

A minority of patients, between 5 and 10 percent, do not respond to medical therapy and will require surgery. Most ulcerative colitis patients undergo restorative proctocolectomy. This technique involves removing the colon and rectum, then constructing an ileoanal pouch (using your small bowel) to help you retain continence.

At Children’s Health, the most advanced techniques, such as minimally invasive procedures, are used to the remove the colon. These methods reduce pain and scaring.