GastroIntestinal / Gastroenterology

What to know about ulcerative colitis in children

Ulcerative colitis is a form of inflammatory bowel disease that causes inflammation in the large intestine.

The condition is more likely to affect people between 15 and 30 and over 60 years old, but it can develop at any age, including in childhood.

Ulcerative colitis causes swelling, bleeding, diarrhea, and other uncomfortable symptoms. There is no cure, but various treatments can help.

In this article, learn more about ulcerative colitis in children, including the symptoms, treatment options, and how to help a child cope.

Causes

mother cuddling young son
Genetics may be one cause of childhood ulcerative colitis.

The exact cause of ulcerative colitis in children is unknown.

It may be due to germs that trigger an inflammatory reaction in the child’s colon.

Ulcerative colitis can also run in families, meaning there may be a genetic link.

Many children with the condition also have a close relative that has it.

Risk factors

While ulcerative colitis can develop in anyone, according to the National Institute of Diabetes and Digestive and Kidney Diseases, it is more common in people who:

  • are between 15 and 30 years old
  • are 60 years old or above
  • have a family member with ulcerative colitis or another form of inflammatory bowel disease (IBD)
  • are of Jewish descent


Symptoms

Children with ulcerative colitis can experience a variety of symptoms, ranging from mild to severe. Symptoms are usually related to inflammation.

Like adults, children with ulcerative colitis will go through periods of remission with little to no symptoms, followed by flares when the symptoms return.

Symptoms can include:

young girl with stomach ache sitting on sofa
Ulcerative colitis can cause abdominal pains.
  • abdominal pain
  • bloody diarrhea
  • loss of appetite
  • weight loss
  • fatigue
  • loss of body fluids and nutrients
  • rectal bleeding
  • anemia

Some children also experience symptoms that do not seem related to their digestive system:

  • joint pain
  • rashes
  • skin lesions
  • eye inflammation
  • liver disorders
  • kidney problems
  • osteoporosis

Along with physical symptoms, ulcerative colitis in children may impact their mental health.

Some potential mental health and emotional changes include:

  • anger
  • mood swings
  • feeling different
  • feeling vulnerable
  • frustration
  • stress

They may encounter social problems at school, such as:

  • embarrassment
  • teasing and bullying
  • pressure about food
  • changes in physical stamina
  • changes in concentration

Diagnosis

Children may have a difficult time explaining all their symptoms. A doctor will listen carefully and may do a variety of tests to determine whether the child has ulcerative colitis.

Tests for ulcerative colitis in children can include:

  • blood tests to check for high white blood cells levels indicating immune system problems, and low red blood cell levels indicating anemia
  • stool samples to look for bacteria, parasites, and presence of blood
  • an endoscopy
  • a colonoscopy
  • a barium enema
  • a biopsy


Treatment

young boy sitting on mothers lap at doctors
A doctor may recommend nutritional changes to help treat ulcerative colitis.

There is no cure for ulcerative colitis, but there are various treatment methods that can help reduce symptoms and keep the disease in remission.

The treatment a doctor recommends will depend on:

  • the child’s age
  • their health and medical history
  • the extent of the disease
  • the child’s tolerance for medication, medical procedures, and therapies
  • parental preference and opinion

Treatment methods may include:

  • medication, including steroids, antibiotics, or immunomodifiers
  • nutritional changes
  • hospitalization
  • surgery

While most children with ulcerative colitis will not need surgery, about 25–40 percent may need surgery eventually to remove part of the colon.

Treatment is not limited to dealing with physical symptoms. It is vital to help a child cope with their condition by addressing the emotional, social, and family changes that occur.

Ways to help a child manage their diagnosis include:

  • educating loved ones, friends, and teachers about the condition and treatment
  • getting dietary advice from a dietitian to ensure the child is getting enough nutrients
  • seeing a therapist
  • finding support groups

In some areas, there are summer camps and other activities designed especially for children with IBD. In these programs, the children can get the medical support they need. They may also find it helpful to talk to other children who are dealing with similar symptoms.

Outlook

Ulcerative colitis is a chronic condition. A child will have the condition for the rest of their life but will experience periods of remission between flare-ups.

While there is no cure, doctors can help control the symptoms with proper treatment. In some cases, a child may require surgery.

To help care for the overall well-being of a child with ulcerative colitis, it is essential that a parent or caregiver addresses potential emotional and social changes along with the physical symptoms.

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