Ulcerative colitis is long-lasting (chronic) swelling (inflammation) of the large intestine (colon). Sores (ulcers) may also form on the colon.

Ulcerative colitis is closely related to another condition of inflammation of the intestines that is called Crohn disease. Together, they are frequently referred to as inflammatory bowel disease (IBD).

Ulcerative colitis is caused by increased activity of the immune system in the intestines. The immune system is the system that protects the body against harmful bacteria, viruses, fungi, and other things that can make you sick. When the immune system overacts, it causes inflammation. The cause of the increased immune system activity is not known.

Risk factors of ulcerative colitis include:

  • This includes:
    • Being 15–30 years old.
    • Being older than 60 years old.
  • Having a family history of ulcerative colitis.
  • Being of Jewish descent.

Common symptoms of ulcerative colitis include rectal bleeding and diarrhoea. There is a wide range of symptoms, and a person’s symptoms depend on how severe the condition is. Additional symptoms may include:

  • Pain or cramping in the belly (abdomen).
  • Fever.
  • Fatigue.
  • Weight loss.
  • Night sweats.
  • Rectal pain.
  • Feeling the immediate need to have a bowel movement.
  • Nausea.
  • Loss of appetite.
  • Anaemia.
  • Joint pain or soreness.
  • Eye irritation.
  • Certain skin rashes.
  • Constipation.

In children, additional symptoms may include:

  • Slow growth.
  • Delayed puberty.
  • Irregular menstrual periods.
  • Problems with other organs in the body.

Ulcerative colitis may be diagnosed by:

  • Medical history and physical exam.
  • Blood tests and stool tests.
  • X-rays.
  • CT scans.
  • For this test, a flexible tube is inserted into your anus and your colon is examined.
  • Examination of a tissue sample from your colon (biopsy).

Treatment for ulcerative colitis may include medicines to:

  • Decrease inflammation.
  • Control your immune system.

Surgery may also be necessary.

There is no cure for this condition, but it can be managed. Treatment depends on the child’s age and the severity of the disease. Treatment often involves medicines to reduce inflammation or to help with symptoms. Some medicines can affect growth, so children who take medicines may need to have their height and weight checked often. They may also need to take nutritional supplements.

Severe flare-ups may need to be treated at a hospital. Treatment in a hospital may involve:

  • Resting the bowel. This involves not eating or drinking for a period of time.
  • Giving medicines through an IV tube.
  • Giving fluids and nutrition through:
    • An IV tube.
    • A tube that is passed through the nose and into the stomach (nasogastric tube or NG tube).
  • Surgery to remove the affected part of the colon. This may be done if other treatments are not helping.

This condition increases the risk of colon cancer, so children who have this condition will need to be watched for colon cancer throughout life.

Medicines and vitamins

  • Take medicines only as directed by your doctor.Do not take aspirin.
  • Ask your doctor if you should take any vitamins or supplements.
  • Keep a diet journal to help identify foods that cause your child’s condition to flare up.
  • Have your child avoid foods that cause the condition to flare up.
  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Have your child eat a well-balanced diet.
  • Give your child vitamins as needed.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.


  • Exercise regularly.
  • Limit alcohol intake to no more than 1 drink per day for nonpregnant women and 2 drinks per day for men. One drink equals 12 ounces of beer, 5 ounces of wine, or 1½ ounces of hard liquor.

Eating and drinking

  • Drink enough fluid to keep your urine clear or pale yellow.
  • Ask your health care provider about the best diet for you. Follow the diet as directed by your health care provider. This may include:
    • Avoiding carbonated drinks.
    • Avoiding popcorn, vegetable skins, nuts, and other high-fibre foods when you have symptoms of ulcerative colitis.
    • Eating smaller meals more often.
    • Keeping a food diary. This may help you to find and avoid any foods that make you feel not well.
  • Limit your caffeine intake.

General instructions

  • Keep all follow-up appointments as directed by your health care provider. This is important.
  • DO take medicine as prescribed.
  • DO ask your health care provider if you should take vitamins, minerals, or iron replacement.
  • DO try to keep to normal physical activity.
  • DO see your health care provider regularly. Periodic colonoscopy is important to watch for cancerous changes.
  • DO call your health care provider if you get fever or chills, increased number of bowel movements, or increased bleeding.
  • DO call your health care provider if your abdomen becomes swollen, pain increases, or vomiting starts.
  • DON’T use aspirin. It increases the risk of bleeding.
  • DON’T drink coffee and alcohol in excess. Limit roughage (raw fruits and vegetables). These can make diarrhoea worse.
  • Your symptoms do not improve or get worse with treatment.
  • You continue to lose weight.
  • You have constant cramps or loose bowels.
  • You develop a new skin rash, skin sores, or eye problems.
  • You have a fever or chills.
  • Your child has a flare-up even with treatment.
  • Your child’s condition gets worse.
  • Your child has new symptoms.
  • Your child is depressed.
  • Your child is avoiding school or other activities.
  • Your child has a fever.
  • You have bloody diarrhoea.
  • You have severe pain in your abdomen.
  • You vomit.
  • Your child has severe bleeding from the rectum.
  • Your child has severe abdominal pain.
  • Your child’s abdomen swells (abdominal distension).
  • Your child’s abdomen is tender to the touch.
  • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.

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