Pediatric Ulcerative Colitis

What is Pediatric Ulcerative Colitis?

Pedi ulcerative colitis is an inflammation, or painful swelling, of the lining of the large intestine, or colon. The inflammation can wear away areas of the lining of the colon leaving sores or ulcers. These sores can be very painful and bleed. They can also cause the bowel to empty often with diarrhea.

Knowing where the inflammation is along the large intestine helps your child’s doctor to decide the type of ulcerative colitis your child has

  • ulcerative proctitis: inflammation of the rectum / lower colon
  • pancolitis: inflammation that affects the entire colon
  • distalcolitis: inflammation of the left side of the colon

Pediatric ulcerative colitis can be a chronic condition. This means that your child may have to manage their disease throughout their life. Some children have long periods of remission, sometimes years, when they experience few or no symptoms of the disease. However, the disease will usually come back at different times during your child’s life.

Symptoms can usually be well controlled with treatment and sometimes surgery can offer a cure.

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We don’t know what caused your child to have pedi ulcerative colitis. Research suggests that the cause of IBD is a combination of 3 main factors:

  • genetics
  • immune system
  • environment

though it is not known yet exactly how these three factors work together. 
What we do know is that approximately 1.4 million Americans suffer from IBD (Crohn’s disease and ulcerative colitis). We know that Pediatric IBD can run in families, many children having a family member who also has the disease. We know that Pediatric IBD affects boys and girls equally and affects about 100,000 children just like yours.


Your child will have a physical exam and you will be asked to give a medical history. Your child’s doctor may also want to have some tests taken to help decide is your child has pediatric ulcerative colitis.

  • Lab tests (blood, stool)
  • Endoscopic procedures (colonoscopy, sigmoidoscopy)
  • X-rays (Lower GI series, Abdominal CT Scan)

Blood tests can be used to look for:

  • low blood counts such as anemia or low iron levels
  • bleeding or infection in the colon
  • high white blood cell count showing inflammation
  • whether or not a treatment is working

Stool samples can be used to look for:

  • infection in the colon or rectum
  • blood in the stool
  • inflammation

X-rays can be used to:

  • decide if your child has pediatric ulcerative colitis
  • find where the disease is along the colon

Endoscopy gives the doctor more information about your child’s pediatric ulcerative colitis by using a lighted scope to see inside areas of the intestine. Endoscopy is thought to be the best way to get a definite diagnosis.


Symptoms can begin slowly or come on suddenly and progress quickly. Your child’s symptoms can be very different at times from mild to serious. Symptoms can be well-controlled with proper treatment and surgery can offer a cure in some children.

Common symptoms can include:

  • frequent diarrhea
  • stomach pain or cramping
  • fevers
  • fatigue or unexplained tiredness
  • blood in your child’s stool
  • anemia or low iron levels
  • weight loss
  • joint, skin or eye irritations



Common complications of ulcerative colitis can include:

  • Nutritional deficiencies or lack of age-appropriate amounts of proteins, calories and vitamins can often be a serious problem in children with ulcerative colitis. These deficiencies can be caused by poor absorption or too few calories taken in on a daily basis.
  • Toxic Megacolon or an infection in the large intestine that can cause a quick widening of the colon. This is a very serious complication because the colon can burst.
  • Other health problems that can come with pediatric ulcerative colitis

Children with pediatric ulcerative colitis can also have other problems like:

  • arthritis or joint problems
  • skin problems
  • anemia or not enough iron in the blood
  • osteoporosis or weak bones
  • delayed growth

Some of these problems can get better during treatment for your child’s ulcerative colitis and others will need to be treated separately.

One of the most important health problems for children with Crohn’s disease is a lack of growth or delayed development. Childhood is a time when nutrition has the most significant impact on growth. If a child is not able to get enough calories and nutrients they will not grow and develop at a normal rate.

It is very important that the symptoms of this problem be found early and treated so that your child’s growth can return to normal.


Treatment of your child’s ulcerative colitis can include:

  • medications
  • nutrition supplements
  • surgery
  • combination of these

The goals of treatment are to:

  • control inflammation
  • correct nutritional deficiencies
  • relieve and/or control symptoms

Treatment of your child’s ulcerative colitis can depend on:

  • where the disease is and how serious it is
  • other complications
  • whether or not your child has responded to other treatments

Though surgery can sometimes offer a cure for ulcerative colitis, symptoms can be well-controlled with proper treatment.

When to call the doctor

Your healthcare provider needs to know if your child has any of the symptoms in this list.

  • temperature above 101 degrees F
  • stomach pain or cramps that are out of the ordinary and do not go away
  • more than the usual number of bowel movements in a day
  • a change in the consistency of your child’s bowel movements
  • blood in the bowel movement or a change in the amount of blood
  • new rectal pain
  • rectal bleeding
  • throwing up for more than 3-4 hours
  • vomit that has bile in it (yellow/green color)
  • bloated stomach
  • tiredness that doesn’t go away
  • rashes, especially on the lower legs
  • swelling or pain in the joints
  • swollen or red eyes

Remember, you know your child best. Trust your judgment. If your child is experiencing something that you are not sure about or that makes you feel uncomfortable, let your healthcare provider know right away.


Still have questions?