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Patient education: Ulcerative colitis in children (The Basics)

Patient education: Ulcerative colitis in children (The Basics)

What is ulcerative colitis? — Ulcerative colitis is a condition that causes diarrhea, belly pain, and bloody bowel movements. These symptoms happen because the large intestine becomes inflamed and gets sores called "ulcers." The large intestine is part of the digestive system. It is also called the colon (figure 1).

What are the symptoms of ulcerative colitis in children? — Symptoms can be mild or severe. They can include:

Diarrhea that often has blood in it

Belly pain

Weight loss

Tiredness

Fever

Joint pain, eye irritation, or skin rashes

Is there a test for ulcerative colitis in children? — Yes. Doctors can do the following tests:

Blood tests

Imaging tests – Such as X-rays, CT scans or MRI scans. Imaging tests create pictures of the inside of the body.

A test called a "colonoscopy" – This test looks at the lining of the colon. During this test, a doctor puts a thin tube into the rectum (the lower part of the large intestine) and moves it up into the colon (figure 2). The tube has a camera on it. It also has tools attached so the doctor can take samples of tissue to look at under a microscope. Sometimes doctors do a test called an "upper endoscopy" at the same time. During this test, the doctor looks at the upper part of the digestive system (figure 3).

How is ulcerative colitis in children treated? — That depends on each child's symptoms and other factors. Treatments can include:

Medicines that go directly into the rectum – Doctors give these medicines to children with ulcerative colitis that affects only the rectum.

Medicines the child takes by mouth – A common type is called "5-ASA." (If your child has trouble swallowing pills, the doctor can give your child liquid medicines or powders you put in foods or drinks.)

Steroid medicines – If other medicines do not work, doctors can give steroid medicines to reduce swelling. These are not the same as the steroids some athletes take illegally. Steroid medicines are usually taken for a few weeks or months at a time.

Stronger medicines for severe cases – These medicines work on the immune system to protect the colon from damage. Common ones are "6-mercaptopurine," "azathioprine" and anti-tumor necrosis factor (anti-TNF) medicines such as "infliximab" and "adalimumab."

Some children with severe symptoms need treatment in the hospital until the symptoms get better.

Ulcerative colitis and some of the medicines that treat it can affect your child's growth. During treatment, the doctor will check your child's height and weight often to make sure they are growing as normally as possible.

Will my child need surgery? — When medicines do not work, doctors can do surgery to remove the colon. After the colon is removed, ulcerative colitis does not come back.

When doctors do surgery for ulcerative colitis in children, they can remove the colon and rectum. After this, they can:

Connect the rest of the intestine to the anus right away. Children who have this surgery can have bowel movements the normal way.

Wait until later to connect the intestine to the anus. This helps the intestine heal. Children who have this surgery can no longer have bowel movements in the normal way. Instead, their bowel movements come out through a hole in the belly (figure 4). A plastic bag catches the waste.

Is my child at risk for colon cancer? — If your child has ulcerative colitis, they can have an increased risk of colon cancer. The risk for colon cancer starts about 10 years after ulcerative colitis is found. After that, your child should have a colonoscopy every 1 or 2 years. Doctors can look for colon cancer and treat it if they find it.

More on this topic

Patient education: Bloody stools (The Basics)
Patient education: Diarrhea in children (The Basics)
Patient education: Stomach ache and stomach upset (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Crohn disease in children (The Basics)
Patient education: Colectomy (The Basics)

Patient education: Blood in bowel movements (rectal bleeding) in babies and children (Beyond the Basics)
Patient education: Chronic abdominal pain in children and adolescents (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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