Pediatric Ulcerative Colitis

What is pediatric ulcerative colitis?

Pediatric ulcerative colitis is a chronic inflammatory bowel disease that impacts children. Inflammation flares up throughout a patient’s life and affects the large intestine, specifically, the inside of the rectum and colon. Ulcerative colitis can be diagnosed at any age; in children, it can potentially slow growth. However, colitis in children is treatable and generally not life-threatening or life-shortening. The major differences between ulcerative colitis diagnosed in adults versus children are the possibilities of slowed physical growth and the impact on a child’s emotional health. Physically, abdominal pain and other symptoms caused by chronic inflammation can reduce a child’s appetite and nutrient absorption. Emotionally, it’s hard enough for adults to accept a chronic condition that requires bathroom dependency and a higher risk of bathroom accidents. For children still trying to learn self-confidence and socialization skills, it can be devastating. On its own, ulcerative colitis is rare. In North America, it affects an estimated 40 to 240 out of every 100,000 people, or about 750,000 in total. It’s primarily found in North America and Western Europe among whites and people of Ashkenazi Jewish descent. Pinning down numbers for pediatric patients is a little harder, but it’s thought that one out of every ten inflammatory bowel disease patients (which includes those with Crohn’s disease) are under the age of 18.

What are the symptoms of pediatric ulcerative colitis?

Along with delayed growth, children with ulcerative colitis can have a variety of symptoms caused by bowel inflammation, including:

• Diarrhea, sometimes with blood, pus, or mucus
• Abdominal pain and cramping
• Feeling the need to go urgently
• Intestinal bleeding
• Nausea
• Fatigue
• Fever
• Loss of appetite
• Weight loss

In some cases, people with ulcerative colitis can experience:

• Red, painful, and itchy eyes
• Mouth sores
• Joint swelling and pain
• Tender bumps, ulcerations, or other skin problems
• Osteoporosis
• Kidney stones

What treatments are available for pediatric ulcerative colitis?

Ulcerative colitis treatments are designed to control flares and help the colon heal. Medications can include:

• Anti-inflammatory medications that reduce immune system activity or the inflammatory processes
• Corticosteroids
• Biologic therapies
• Acetaminophen to help relieve mild pain

In some cases, surgery may be required to remove portions of the colon (or the entire colon) if colitis doesn’t respond to therapy or if there are severe problems. It’s important for parents to talk to their child’s doctor to find out which treatment approach is most appropriate and what to expect with each. In addition, doctors may encourage diet and nutrition plans that reduce diarrhea and gas and promote fluid and nutrient absorption. This diet can include eating smaller amounts of food, drinking plenty of water throughout the day, and avoiding high-fiber and fatty, greasy sauces and fried foods. A nutritionist may want children with pediatric ulcerative colitis to eat foods higher in protein and calories, and may suggest liquid supplements given either orally or through tube feeding, directly into the stomach or small bowel (enteral nutrition). Fortunately, with treatment, ulcerative colitis is manageable. By finding and sticking to a treatment regimen that keeps the disease in remission, children can grow and develop normally. In addition, to ensure that children who need extra help because of a medical condition receive an education equivalent to their peers, schools are required to make special accommodations. This is called a 504 Plan, and it’s required of all schools receiving federal education dollars.

Where can I find more information about pediatric ulcerative colitis?

• Crohn’s & Colitis Foundation of America
• U.S. National Library of Medicine
• Medline Plus
• Boston Children’s Hospital
• National Organization for Rare Disease (NORD)