Children's Hospital Colorado

Ulcerative Colitis in Kids

What is ulcerative colitis?

Ulcerative colitis is a type of inflammatory bowel disease, or IBD. Ulcerative colitis is a chronic disease of the large intestine, or colon, in which the organ lining becomes inflamed and develops tiny open sores called ulcers. The combination of inflammation and ulcers can cause stomach pain and bloody diarrhea.

The other main type of IBD is Crohn's disease. Crohn's disease can affect any part of the digestive system, while ulcerative colitis affects only the large intestine.

IBD is not the same as irritable bowel syndrome, or IBS, a disorder that affects the muscle contractions of the large intestine. People with IBS do not experience inflammation in the intestine or damage to the intestinal lining.

What causes ulcerative colitis in children?

The cause of ulcerative colitis is unknown. Research has identified both hereditary (family genetics) and environmental factors as important. Although they do not cause ulcerative colitis, stress and diet can aggravate the condition.

A child may develop ulcerative colitis when their digestive system mistakes harmless bacteria for harmful bacteria. Everyone's gastrointestinal tract contains harmless bacteria, many of which help digest food. But in people with ulcerative colitis, the body launches an immune system attack against the harmless bacteria because it thinks that bacteria shouldn’t be there. When this happens, cells travel out of the blood and into the intestines to produce inflammation — a normal response that typically goes away on its own, except in people with ulcerative colitis. The inflammation causes ulcers, damage to the lining of the large intestine and noticeable symptoms.

Who gets ulcerative colitis?

Ulcerative colitis affects approximately 700,000 Americans. Males and females are equally likely to be affected. In children, the typical age range is 12 to 14, although cases are on the rise in children under 10.

While ulcerative colitis tends to run in families, researchers haven't been able to establish a clear hereditary pattern. Studies show that up to 20% of individuals with ulcerative colitis also have a close relative with the disease.

What are the signs and symptoms of ulcerative colitis in children?

Pediatric colitis symptoms can include:

  • Persistent diarrhea
  • Rectal bleeding
  • Urgent need to poop
  • Abdominal cramps and chronic pain
  • Sensation of incomplete poops

General symptoms that may also be associated with ulcerative colitis can include:

  • Fever
  • Loss of appetite
  • Weight loss or poor weight gain
  • Tiredness
  • Night sweats
  • Recurrent mouth sores
  • Achy or swollen joints

The symptoms of ulcerative colitis come and go. Patients may experience lengthy periods of time without discomfort, called remission. Periods of remission can last for months or even years, but symptoms will return.

If your child is showing signs of ulcerative colitis, a gastrointestinal doctor can provide an evaluation.

What tests are used to diagnose ulcerative colitis?

There are several tests that can help diagnose ulcerative colitis in kids. This can include:

  • Physical examination: a complete body check evaluating your child's height, weight, eyes, ears, mouth, heart and lungs, as well as the abdominal and anal regions
  • Medical history review: an evaluation of previous doctor visits and hospital trips
  • Stool test: a poop sample helps us rule out infection and check for inflammation
  • Upper intestinal endoscopy and colonoscopy with biopsies: a thin tube with a lighted camera on the end to view linings of the digestive system; we take a tissue sample, or biopsy, for lab testing
  • MR enterography (a type of magnetic resonance imaging, or MRI), CT enterography or upper gastrointestinal small bowel follow through: these imaging techniques produce detailed pictures of your child's digestive system
  • Blood tests: a sample of blood is used to identify inflammatory markers, liver and kidney function, protein stores, iron and vitamin D and sometimes other important minerals that could support a diagnosis of ulcerative colitis

Why choose us for ulcerative colitis testing?

Our Pediatric Inflammatory Bowel Disease Center specializes in diagnosing ulcerative colitis in children. We exclusively treat kids, which means we're experienced in all the ways kids are different than adults. Kids' vital signs and test results look different. Additionally, kids often require a more personalized care approach. Here, we recognize the recommended tests for ulcerative colitis can be scary, which is why our specialists do everything they can to help make the process easy and interactive.

How is ulcerative colitis treated?

We treat ulcerative colitis in a variety of ways depending on the severity of your child's case. In general, our treatment methods work to decrease inflammation and repair damage to the large intestine.

Medication treatment is most common. There are several medication options, and we make a recommendation based on specific factors of your child's condition. Ulcerative colitis is chronic, which means your child will likely need to stay on medication for the rest of their life. Proper monitoring and dosing are important. If the disease remains persistent, surgery may be necessary to remove the large intestine.

Our digestive specialists perform research and participate in clinical trials to evaluate new treatments for ulcerative colitis in children, meaning we have access to the most innovative treatments available.

Why choose us to treat your child's ulcerative colitis?

Our team includes experts from several different areas of medicine. Board-certified pediatric gastroenterologists, advance practice nurses, nurse coordinators, clinical social workers, dietitians, pediatric radiologists, surgeons, dermatologists, endocrinologists, psychologists and child life specialists work together to provide seamless care for children diagnosed with ulcerative colitis. In fact, our Pediatric Inflammatory Bowel Disease Center is the only program in the region to provide this multidisciplinary approach to care.

We're also the only program that participates in the ImproveCareNow collaborative, a community of patients, parents, clinicians and researchers who are dedicated to improving the lives of children with ulcerative colitis and other types of IBD. Our expertise and innovative approach to care is nationally renowned, and we're equipped to provide patients and their families with the information and skills needed to successfully manage ulcerative colitis throughout childhood.

Learn more about the ulcerative colitis treatment options we offer.

What is the difference between ulcerative colitis and Crohn's disease?

Though both conditions are types of inflammatory bowel disease, Crohn's disease can affect any part of the digestive system, while ulcerative colitis affects only the large intestine.

Helpful resources

  • The Crohn's and Colitis Foundation offers information and community support programs for patients and their families, as well as a summer camp experience called Camp Oasis.
  • Take Steps is a fundraising and advocacy group for ulcerative colitis and Crohn's disease.
  • provides useful educational material and links.

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