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

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It usually affects people when they are between the ages of 15 and 30 years or over 60 years, 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 and treatment options and how to help a child cope.

The exact cause of ulcerative colitis in children is unknown.

However, experts believe that it may start when bacteria or a virus triggers an inflammatory reaction in the colon.

Ulcerative colitis can also run in families, meaning that there may be a genetic link. Many children with the condition also have a close relative who has it.

Risk factors

Ulcerative colitis can develop in anyone. However, 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 IBD
  • are of Jewish descent

Children with ulcerative colitis can experience a variety of symptoms, which can range in severity from mild to severe. The symptoms are usually related to inflammation.

Like adults, children with ulcerative colitis will go through periods of remission with few or no symptoms. These typically precede flares, when the symptoms return.

Symptoms can include:

  • stomach pain
  • bloody diarrhea
  • loss of appetite
  • weight loss
  • fever
  • fatigue
  • loss of bodily fluids and nutrients
  • rectal bleeding
  • anemia

Some children also experience symptoms that do not seem related to their digestive system. These may include:

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

As well as producing physical symptoms in children, ulcerative colitis may affect their mental health.

Children with the condition may experience:

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

They may also encounter problems at school, such as:

  • embarrassment
  • teasing and bullying
  • peer pressure regarding the foods they eat
  • changes in physical stamina
  • changes in concentration

Children may find it difficult to explain all of their symptoms. A doctor will listen carefully, carry out a physical exam, and possibly perform a variety of tests to determine whether the child has ulcerative colitis.

These tests may include blood tests, which can check for high white blood cell levels, indicating immune system problems, and low red blood cell levels, signifying anemia.

Other tests for ulcerative colitis in children can include:

  • the analysis of stool samples to look for bacteria, parasites, and the presence of blood
  • a colonoscopy, which is a kind of endoscopy
  • a barium enema
  • a biopsy

There is no cure for ulcerative colitis, but treatments are available to help reduce symptoms and keep the disease in remission.

The treatment that 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
  • the preference and opinions of parents or caregivers

Treatment methods may include:

  • medication, including biologics and other drugs that affect the immune system
  • antibiotics, if there is a risk of infection
  • dietary changes
  • hospitalization
  • surgery

Research suggests that 5–29% of children may eventually need surgery to remove part of the colon.

Providing support

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 its treatment
  • getting advice from a dietitian to ensure that the child is getting enough nutrients
  • taking them to see a therapist
  • finding support groups

In some areas, there are summer camps and other activities designed especially for children with IBD. These programs provide children with the medical support that they need. A child may also find it helpful to talk to other children who are dealing with similar symptoms.

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.

Although there is no cure, treatment can help children manage the symptoms. In some cases, they may require surgery.

To help care for the overall well-being of a child with ulcerative colitis, it is essential that parents or caregivers address the potential emotional and social changes that occur alongside the physical symptoms.

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