Ulcerative Colitis - Kids & Teens
What is IBD?
When your doctor first told you about ulcerative colitis, he or she
may have also mentioned 'Inflammatory bowel disease', or IBD. The
word 'IBD' is used for a group of diseases that cause pain and
swelling (inflammation) in the
digestive system. Ulcerative colitis is one type of IBD that
affects the large intestine (colon and rectum). Another type of IBD
called Crohn's disease can affect any part of the digestive system,
for example the mouth, stomach, small or large intestine. Having IBD
can be difficult sometimes, but with help from your doctor and by
making a few changes in your life you should be able to carry on
Here are some answers to questions people often ask about IBD.
However, because ulcerative colitis affects different people in
different ways, you should not worry if you find your situation is
slightly different than someone else's. We suggest you and your
parents read this together so you can talk about it with them.
How does IBD make you feel?
The most common IBD symptoms are abdominal pain, cramping, tiredness
(fatigue), runny stool (diarrhoea) and weight loss. Other symptoms
may include bloody diarrhoea, slight fever, anaemia (low levels of
red blood cells in the blood which can make you feel tired, faint or
breathless), exhaustion (extreme tiredness) and (in children) slowed
Both ulcerative colitis and Crohn's disease are ongoing (chronic)
with times when symptoms get worse (called flares, or attacks) and
other times when symptoms get better (remission). Although the
symptoms can make you feel unwell and may make your daily activities
difficult, they can usually be managed with a combination of care,
medication, hospitalisation and (sometimes also) surgery. Many
people find that in well managed IBD, making some simple changes to
their everyday lives enables them to continue their normal
IBD can start at any age. Both Crohn's disease and ulcerative
colitis are found worldwide, although they are more common in the
Western world. About 2.2 million people in Europe have IBD. Regional
differences range from 1/1000 to 1/500, with the highest numbers in
IBD affects men and women equally, although
ulcerative colitis is slightly more common in men and Crohn's
disease is slightly more common in women.
Although the exact causes of IBD are unknown, they are believed to
be related to changes in the body (immune system) brought about by
an environmental trigger in people who are genetically prone to the
disease. A combination of factors may play a role, including
bacteria, viruses, genetics, smoking and over-the-counter pain
medicines. Other factors, such as stress and diet, are not believed
to cause IBD, although they may be involved in worsening symptoms
for some people.
Neither ulcerative colitis nor Crohn's disease is contagious,
meaning you cannot catch it from someone else or spread it to anyone
if you have it. This should not be confused with the fact that the
tendency to develop the disease may be hereditary (passed on through
the genes), since relatives of people with IBD are at a slightly
greater risk of developing the disease. However, other factors (such
as environmental triggers) are also believed to play a role in
developing the disease for these people.
Both ulcerative colitis and Crohn's disease can cause other
problems, or complications, in some people. With ulcerative colitis,
for example, bleeding may cause anaemia (low levels of red blood
cells in the blood, which can make you feel tired, faint or
With Crohn's disease, scarring and thickening of the intestine walls
can create a narrowing of the intestine wall, which is called a
stricture, leading to constipation, bloating and pain. Nutritional
problems may also happen if the body cannot use vitamins or minerals
Although not everyone will have these problems, if they do arise,
they may also need medical care in addition to treating ulcerative
colitis or Crohn's disease.
Not everyone will have these problems, but for some people IBD may
also affect other parts of the body, such as the joints, eyes,
mouth, liver, gallbladder, skin or kidneys. Although some of these
problems may improve with the treatment and management of IBD,
specific treatment may also be needed.
Treatment with medicine is usually the first approach to managing
IBD. The type of treatment you will be given depends on several
things - such as whether you have ulcerative colitis or Crohn's
disease, the extent of the disease, and the impact of your symptoms
on your daily life.
For people with ulcerative colitis, treatment depends on the amount
of the large bowel affected and amount of inflammation. For example,
disease in the lower part of the bowel may be treated with drugs
given directly into the rectum with an enema or suppository. A
medicine called mesalazine may be given by mouth. Steroid tablets
(such as prednisolone) may be given in more severe cases or if more
of the bowel is affected. Immunosuppressants may also be used to
help reduce the activity of the body's immune system, which causes a
lot of the damage to the bowel. After symptoms are reduced, many
people take medicine to keep symptoms from returning; this is called
For Crohn's disease, there are generally the same options as those
used for ulcerative colitis. However, with Crohn's disease, drugs
that suppress the immune system (azathioprine, 6-mercaptopurine or
methotrexate) are used more often to help control the inflammation
and as maintenance therapy to help keep symptoms from coming back.
Active Crohn's disease is usually treated with steroid tablets (eg,
prednisolone) and sometimes antibiotics are also used. When other
drug therapy does not work well, an anti-TNF drug may be given by
infusion (drip) in the hospital or by injection at home.
With both diseases, surgery may be needed if medicine does not work
well or if there are other problems also. If you are worried about
the possibility of needing surgery, speak with your doctor about
For more details on treatment options for Crohn's disease and
ulcerative colitis, please see
Treatment Plan for UC.
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Do you have any other questions about IBD that you are still
wondering about? Was there anything on this page that you didn't
understand? Write these things down so you can bring them with you
when you visit the doctor. Also ask your mum or dad if they have any
questions they would like to ask too.
For parent information