Ulcerative Colitis - Kids & Teens

What is Ulcerative Colitis?

Now that you have a good general understanding of IBD, you are ready to learn more about ulcerative colitis. Ulcerative colitis is a disease that causes inflammation (pain, sores and swelling) in the inside lining of the colon (large intestine) or rectum. This causes urgent and bloody diarrhoea, and tiredness. The effects of the disease vary depending on how much of the colon is affected, and symptoms change over time with periods called flare-ups in between symptom-free periods called remission. (For an illustration and details on the different types of ulcerative colitis and the areas they affect, see How the digestive system works.

Ulcerative colitis can be difficult to diagnose because its symptoms are similar to other intestinal disorders and to another type of Inflammatory Bowel Disease (IBD) called Crohn's disease. Crohn's disease differs from ulcerative colitis because it causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system, including the small intestine, mouth, esophagus and stomach.

• What are the symptoms of Ulcerative Colitis?                            back to top
  
  The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhoea. Other symptoms include loss of appetite, weight loss, fever, tiredness, joint pain, anaemia (low levels of red blood cells in the blood, causing dizziness, faintness or tiredness), or loss of body fluids and nutrients. In children, there may be delayed growth as a result.

• How is Ulcerative Colitis diagnosed?                                                 back to top

   

  Many different tests are used to diagnose ulcerative colitis. A physical examination and medical history are usually the first step. Blood tests may also be done to check for anaemia, which could suggest bleeding in the colon or rectum, or they may uncover a high white blood cell count, which is a sign of inflammation somewhere in the body.

  A stool sample can also reveal white blood cells, which might be an indication of ulcerative colitis or inflammatory disease. A stool sample also allows the doctor to detect bleeding or infection in the colon or rectum caused by bacteria, a virus or parasites. Ruling out these causes can be useful in diagnosing ulcerative colitis.

  A colonoscopy or sigmoidoscopy is the most commonly used method for making a diagnosis of ulcerative colitis and ruling out other possible conditions, such as Crohn's disease, diverticular disease or cancer. For both tests, the doctor inserts an endoscope - a long, flexible, lighted tube connected to a computer and TV monitor - into the anus to see the inside of the colon and rectum. The doctor will be able to see any inflammation, bleeding or ulcers on the colon wall. During the examination, the doctor may do a biopsy, which involves taking a sample of tissue from the lining of the colon to view with a microscope.

  Before the examination, you will need to drink a special preparation which will make you go to the toilet often. This is to clear the digestive system, so the camera can move about, and clearly see the walls of the bowel. Although the examination may be uncomfortable, it shouldn't be painful. Your doctor can discuss options for pain relief with you. If a biopsy is taken, usually this doesn't cause any discomfort.

  Sometimes X-rays such as a barium enema are also used to diagnose ulcerative colitis. A specially prepared enema containing barium is taken before the test. Barium coats the lining of the gut and shows up as white on X-ray films. The patterns on the films show the doctor which parts of the gut are affected by disease.

   

  CT and MRI scans can also be used to obtain detailed pictures of the digestive system, to help to identify any problems.

   

  In about 10% of people with IBD, it is difficult to determine whether they have ulcerative colitis or Crohn's disease, due to similar or overlapping symptoms.

• Can other parts of the body be affected also?                           back to top

   

  Other parts of the body may also be affected in some people with ulcerative colitis, such as the joints, eyes or liver. Some of these problems go away when the ulcerative colitis is treated, but some need specific treatment on their own as well.

   

• Who gets Ulcerative Colitis?                                                              back to top

   

  About 1.2 million people in Europe have ulcerative colitis. That is about 1 in 1,500 people. It can develop at any age, but most commonly starts between the ages of 15 and 40. Slightly more males than females are affected.

   

• What causes Ulcerative Colitis?                                                   back to top

   

  The cause of ulcerative colitis is not yet known, although several factors may play a role, including viruses, bacteria, genetics and smoking. It tends to run in families. One theory is that a bacteria or virus may trigger the immune system to cause inflammation in parts of the digestive system in people who are genetically prone to develop the disease.

   

• How does Ulcerative Colitis progress?                                          back to top

   

  Ulcerative colitis is a chronic (ongoing) disease, with times when symptoms flare-up (relapse) and times when there are few or no symptoms (remission). The severity of symptoms, and how often they occur, varies from one person to the next. About half of people with ulcerative colitis have mild symptoms. Others have frequent fevers, bloody diarrhoea, nausea and severe abdominal cramps. Usually, however, with treatment, symptoms can be managed well and it still possible to do the things you want to and live life to the full.

   

• What are the possible complications of Ulcerative Colitis?        back to top

   

  There are several possible complications of ulcerative colitis. They vary depending on the amount of inflammation in the rectum and the colon. Not everyone will have these problems, but here are a few examples:

   

  o      Abdominal distension - a sudden and severe expansion of the colon which can lead to a condition called toxic megacolon, in which case the colon is at risk of rupturing (when small tears or holes form). Surgery may be needed to prevent rupture of the bowel.

   

  o       Perforation - A small hole that forms in the wall of the gut. The contents of the gut can leak out and cause infection or an abscess inside the abdomen. This can be serious and life-threatening.

   

  o        Severe bleeding - this can become quite serious and require treatment on its own.

   

• Will I need surgery?                                                                   back to top

Most people with ulcerative colitis can manage their illness with medicine. However, sometimes they need to have surgery. After surgery, however, they can usually expect a good quality of life.

If surgery is needed, your doctor will discuss your options with you. Get as much information as possible by talking to your doctors, to nurses who work with people with ulcerative colitis and to other people who have had surgery. Patient support groups can also direct you to other helpful resources and give you the opportunity to meet with other children and their parents who have had similar experiences in the past.

For more information on treatment and surgery for ulcerative colitis, please see, Treatment plan for Ulcerative Colitis.

• What can I do to help manage my illness?                               back to top

   

  Your role in managing Ulcerative Colitis is very important. Here are some of the main things you can do to stay in control of ulcerative colitis:

  • Be involved in the management of your own health every day
  • Know when and how to take care of your own health
  • Follow your management plan and take your medication
  • Ask questions if you are concerned, and seek help if a problem arises

  In between doctor visits, it is important that you follow your treatment plan and know what to do should a problem arise. If you have any of these problems, contact your doctor as soon as possible:

  • Blood in your stool
  • Change in use of toilet (how often or how much) lasting for more than 10 days
  • Belly aches or pain
  • Lots of runny stools (diarrhoea) or bloody diarrhoea
  • Weight loss with no known reason
  • Fever lasting more than 3-4 days
  • Feeling very tired
  • Not feeling hungry or not wanting to eat
  • Stomach sickness (nausea) or throwing up (vomiting) for no known reason

   

Test your knowledge - parent-child activity                                           back to top

Here are a few questions about Crohn's disease to see how much you have learned so far. For each question, select either 'True' or 'False'. See how many you can get right.

1. Ulcerative colitis is a type of inflammatory bowel disease  

(True or False?)                                                    For correct answer click here