Ulcerative Colitis

Ulcerative colitis is one of the two types of inflammatory bowel disease.

As with Crohn's disease:

  • the cause remains unknown
  • the condition appears equally in both sexes
  • seems to appear more in some families

Diagnosis can occur at any time in childhood. Progressive loosening of the stool is usually the first symptom.

Graphic: GI tract regions affected by ulcerative colitis

Diarrhea may start slowly, or quite suddenly. It may be associated with cramping abdominal pain, and with severe urgency to have a bowel movement. The stool may be bloody; anemia may occur if bleeding is severe.

Loss of appetite, followed by weight, loss are common. So is fatigue. Children with ulcerative colitis may fail to develop or grow properly.

Roughly half of ulcerative colitis patients have mild symptoms. Others may suffer from severe abdominal cramping, bloody diarrhea, nausea, and fever.

Symptoms tend to come and go. Flare-ups can be separated by long periods of remission, with minimal or no symptoms.

"Extra-intestinal symptoms" that are not directly associated with the bowel may occur. The muscles, bones, joints, skin, eyes, or liver may be affected. Arthritis is the most common of these problems. Joint, eye, and skin conditions may appear together. These symptoms generally respond to treatment.

In contrast to "gum to bum" profile of Crohn's disease, ulcerative colitis affects only the large bowel and the rectum, and involves only the inner lining of the bowel.

Because the inflammed areas are limited to the large bowel and rectum, surgery may "cure" the illness.

Abdominal bloating may be a complication. Other serious complications are less frequent than in Crohn's disease. They can include:

  • bleeding from deep ulcerations
  • ruptured bowel
  • failure to respond to the usual medical treatments
  • increased risk of colon cancer