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What is ulcerative colitis? — Ulcerative colitis is a condition that causes diarrhea, belly pain, and bloody bowel movements. These symptoms happen because the colon becomes inflamed and gets sores called "ulcers."
The colon is also called the large intestine. It is part of the digestive system (figure 1).
What are the symptoms of ulcerative colitis in children? — Symptoms can be mild or severe. They can include:
●Diarrhea, often with 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 – These include X-rays, CT scans, or MRI scans. Imaging tests create pictures of the inside of the body.
●"Colonoscopy" – This test looks at the lining of the colon. The doctor puts a thin tube with a camera into the anus and moves it up into the colon (figure 2). The tube also has tools attached. The doctor can use these to 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? — This depends on the child's symptoms and other factors. Treatments can include:
●Medicines that go directly into the rectum – The rectum is the lower part of the colon. These medicines only treat ulcerative colitis that is in the rectum.
●Medicines that the child takes by mouth – If your child has trouble swallowing pills, the doctor can prescribe liquid medicines or powders that you put in foods or drinks.
●Steroid medicines – If other medicines do not work, doctors can give steroid medicines. These reduce swelling. 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.
Some children with severe symptoms need treatment in the hospital until their 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. This is to make sure that they are growing as normally as possible.
Will my child need surgery? — If medicines do not work, some children might need surgery to remove the colon and rectum. After the colon is removed, ulcerative colitis does not come back.
Once the colon and rectum are removed, doctors can:
●Connect the rest of the intestine to the anus right away – Children who have this surgery can have bowel movements the normal way.
●Create a stoma – A "stoma" is a hole that doctors create in the belly (figure 4). Then, they connect the intestine to the stoma. This helps the intestine heal. After this surgery, the child's bowel movements come out through the stoma. A plastic bag catches the waste.
Once the intestine has healed, doctors can do a second surgery to connect the intestine to the anus and close the stoma. Then, children can have bowel movements the normal way again.
Is my child at risk for colon cancer? — Children with ulcerative colitis have a higher risk of colon cancer. To check for cancer, your child should have a colonoscopy about 10 years after ulcerative colitis was found. After that, they should have a colonoscopy every 1 to 3 years. Doctors can treat colon cancer if they find it.
Patient education: Bloody stools in children (The Basics)
Patient education: Diarrhea in children (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Stomach ache and stomach upset (The Basics)
Patient education: Crohn disease in children (The Basics)
Patient education: Colectomy (The Basics)
Patient education: Colitis (The Basics)
Patient education: Low-FODMAP diet (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)
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