Ulcerative colitis (UC) causes ulcers and inflammation in the inner lining of the child’s colon and rectum.
Ulcerative colitis is a chronic (reoccurring) condition. The symptoms and their severity can vary — often, children will experience periods of remission where their symptoms are gone. UC often begins slowly, but eventually, becomes more severe.
Symptoms vary along with the severity of the disorder. Problems related to UC extend beyond the GI tract, including:
Experts are not sure what causes ulcerative colitis. They think it might be caused by the immune system overreacting to normal bacteria in the digestive tract.
Ulcerative colitis is most likely to develop in children and young adults between the ages of 15 to 25; however, it can occur at any age. Having a family member with inflammatory bowel disease also increases the likelihood of getting UC.
Medical treatment aims to contain and control intestinal inflammation, limit extra-intestinal involvement and make it possible for patients to lead as active and normal a life as possible.
Outpatient treatment includes the use of anti-inflammatory therapy. Corticosteroids are effective in subduing acute bouts of inflammation, but long-term steroid treatment is not advised due to its harmful side effects.
A minority of patients, between 5 and 10 percent, do not respond to medical therapy and will require surgery.
Most ulcerative colitis patients undergo reconstructive proctocolectomy. This technique involves removing the colon and rectum, then constructing an ileoanal pouch (using your small bowel) to help you retain continence.
At Children’s Health, the most advanced techniques, such as minimally invasive procedures, are used to the remove the colon. These methods reduce pain and scaring.
Severe complications can arise in patients with ulcerative colitis during acute exacerbations of the disease, or as the disease progresses.
Toxic megacolon, an acute form of colon distention, is rare in children, but when it does occur, it is a medical and surgical emergency. Toxic megacolon is thought to be caused when overwhelming inflammation interferes with motility. The ensuing bacterial buildup leads to necrosis and peritonitis.
Children diagnosed with UC have an increased risk for colonic malignancy as they get older. The earlier the onset of the disease, the greater the eventual risk for malignancy:
Because of this strong association, children who have been diagnosed with UC should be scheduled for yearly screenings with surveillance colonoscopy, and a biopsy should be performed to identify any precursor evidence of epithelial dysplasia.