Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) in which the lining of the large intestine (colon) becomes inflamed and ulcers develop, which produce mucus and pus. UC occurs when the body’s immune system mistakes food and other necessary materials in the intestine for invading substances. The immune system then sends white blood cells into the intestinal lining, causing the inflammation and ulcerations.
UC is different from Crohn’s disease in that UC affects the colon and the lining of the colon, while Crohn’s can affect any part of the gastrointestinal tract and all layers of the bowel wall.
What Causes UC?
UC does not have a known cause; however, research suggests a combination of factors:
- Heredity: Children whose parents have IBD are more likely to have UC.
- Immune System: Researchers believe a malfunctioning immune system damages the intestine.
- Environment: Environmental antigens may be a direct cause or a stimulant to the immune system.
Many scientists believe that patients with UC have an abnormal interaction between an infection and the body’s immune system. In this process, inflammation, which is normally produced temporarily to fight the infection, continues even after the infection has cleared.
Approximately 1.4 million Americans are affected by IBD, with 100,000 being children. Risk factors for UC include:
- Ethnicity: Caucasians have the highest risk, especially those of Ashkenazi Jewish heritage.
- Age: UC typically starts before age 30, but can present at any age.
- Family History: Children who have a parent or other close relative with UC are at higher risk.
- Use of Isotretinoin: A certain medication used to treat acne may contribute to UC.
Symptoms of UC
Symptoms of UC typically develop over time, but can appear suddenly and progress quickly in some cases. Your child may experience symptoms ranging from mild to severe without any obvious reason. Symptoms of UC include:
- Frequent diarrhea, often with pus or blood
- Abdominal cramping and pain
- Urgent need to have a bowel movement
- Rectal pain and bleeding
- Unexplained fatigue
- Loss of appetite
- Weight loss
- Anemia or low iron level
- Eye, joint, or skin irritations
- Growth or developmental delay
Children with UC tend to have time periods where symptoms subside and then later flare up. These remission periods can last months or even years, but symptoms do return eventually.
Treating UC in Children
Treatment involves regulating the immune system in order to control and relieve symptoms. With a proper combination of therapies, children with UC can experience a great reduction in symptoms and often long-term remission. Another goal of treatment is to correct deficiencies in nutrition.
Treatment will depend on what type of UC your child is diagnosed with and how severe the symptoms are. The type of UC diagnosed depends on how much of your child’s colon is affected. The condition can range from mild to severe. Medications that have been successfully used to treat symptoms are:
- Anti-inflammatory drugs (to treat localized inflammation)
- Immunomodulators (to suppress the immune system’s response to reduce inflammation)
- Antibiotics (to control or prevent infection)
- Biologic therapies (treatment involves using antibodies to interfere with the disease’s inflammatory process)
Other treatments include:
- Nutritional counseling (maintaining a healthy diet is vital for your child’s continued growth and development)
- Surgery (only in severe cases or when complications arise)
Home and Lifestyle Remedies
If your child is diagnosed with UC, you can make dietary and other lifestyle adjustments to help alleviate symptoms:
- Avoid foods which worsen symptoms (keeping a food diary can help identify when symptoms arise and in conjunction with what foods)
- Drink plenty of water
- Avoid caffeine
- Use multivitamins (getting proper nutrition can be challenging, so vitamin supplements can help maintain health)
- Exercise (reducing stress and depression through exercise can help normalize bowel function)
- Probiotics (live bacteria similar to the natural bacteria in the GI tract that come in tablet, pill, or powder form; your doctor can advise you on the proper amount to improve symptoms)
For educational resources on IBD, visit Crohn’s and Colitis Foundation of America. If you would like more information about gastrointestinal (GI) digestive disorders and nutrition in children, please contact Dr. Mona Dave’s Plano Office or Southlake Office.