Ulcerative Colitis in Children: Symptoms and Treatment

Ulcerative colitis in children is a rare, but quite complex disease. Its consequences can seriously affect the quality of life of these children.

Inflammatory bowel disease (IBD) is a chronic condition with an unclear cause that affects the health and functionality of the digestive tract. Ulcerative colitis is a type of IBD that can manifest in childhood and requires complex and multidisciplinary treatment.

The incidence of this disease in the pediatric population indicates that 2 out of every 100,000 children in the West suffer from it. For this reason, today, we’re going to tell you everything you should know about ulcerative colitis in children. Keep reading!

What is ulcerative colitis?

Ulcerative or ulcerative colitis (UC) is a disease characterized by chronic inflammation of the inner lining of the large intestine and rectum.

These inflammatory lesions manifest themselves through colonic ulcers, which cause symptoms such as pain, bleeding, a sensation of incomplete emptying (tenesmus), and poor bowel function.

Although UC can occur at any age, it’s very common in young people under 20 years of age. And although it’s not common in childhood, its incidence in this age group seems to be on the rise.

What are the causes of ulcerative colitis in children?

The specific cause of this pathology is unknown for sure, but some factors have been found that predispose its development:

• Intestinal pathogenic microorganisms (bacteria, fungi, or parasites) that trigger the inflammatory reaction in the intestine and alter the local immune system.
• Genetic factors, such as a history of UC in direct relatives.

Symptoms of ulcerative colitis in children

The symptoms of ulcerative colitis are varied and their intensity depends on the degree of involvement of the intestines. In some children, the condition results in a mild affectation, while in others, it greatly affects their quality of life.

The manifestations of this disease usually appear suddenly and disappear after a while, but recur with a certain periodicity. Among the most prominent ailments of UC, we can mention the following:

• Loss of appetite
• Chronic diarrhea, in some cases with blood
• Recurring abdominal pain
• Weightloss
• Rectal bleeding
• Asthenia (marked tiredness)
• Fever
• Malnutrition
• Anemia

Similarly, the child may experience symptoms that go beyond the intestinal condition:

• Rashes
• Liver problems
• Joint pain and inflammation (arthritis)
• Eye disorders
• Fragile bones
• Kidney disorders

Some children develop psychological consequences, such as mood swings, stress, or depression.

How is the disease diagnosed?

The diagnosis of ulcerative colitis isn’t always easy, as not all children experience the same symptoms and not all can communicate the discomfort in the same way.

Likewise, there’s no specific test that determines that a child suffers from ulcerative colitis. For this reason, the pediatrician or gastroenterology specialist first performs a complete physical evaluation, assesses the presence of symptoms and the child’s history, and then indicates a series of complementary tests to certify the diagnosis.

Among the most common studies are the following:

• Blood tests
• A barium enema, which identifies possible areas of narrowing or obstruction in the digestive tract
• Stool test, to detect the presence of bacteria, parasites, or blood
• Digestive endoscopy, to observe the appearance of the intestine and to take samples of its walls (intestine biopsy) in order to analyze them under the microscope

Ulcerative colitis treatment

This intestinal condition does not have a definitive curative treatment, but rather an attempt is made to improve the symptoms and avoid complications.

As commented, each child manifests the disease in a particular way, so the treatment depends on the individual.

In general, the most commonly used drugs are those listed below:

• Immunosuppressive drugs: Decrease the intensity of the immune response in the intestines and improve inflammation
• Antidiarrheals
• Aminosalicylates: Help reduce inflammation of the intestine
• Nutritional supplements: These reinforce the supply of iron, calcium, and vitamin D
• A balanced and healthy diet that’s low in fat, fiber, and dairy products, but provides enough calories, nutrients, and protein

In severe ulcerative colitis, a specialist may assess the need for surgery to remove the diseased portion of the intestine to improve the child’s quality of life.

What care should a child with ulcerative colitis have?

The symptoms of this disease are usually absent for long periods of time. However, they can reappear at any moment. Therefore, parents need to provide certain care in order to promote digestive health to better cope with relapses.

Some of the most recommended guidelines include the following:

• Taking the medications indicated by the doctor
• Getting regular exercise
• Attending all periodic medical check-ups, in order to evaluate the correct growth of the child and manage the possible consequences (such as anemia and bone damage)
• Following a dietary guideline indicated by a nutritionist, as the child must consume foods that are rich in nutrients that don’t affect the intestinal tissue

Children with this disease may have problems in their growth and development, as well as difficulties in keeping up with school due to repeated absences. However, with the appropriate interdisciplinary approach, these children can enjoy an adequate quality of life.