Ulcerative colitis is a type of inflammatory bowel disease. It causes inflammation in the colon, also called the large intestine. The inflammation can cause swelling and bleeding, as well as frequent bouts of diarrhea. For a child, these symptoms can be difficult to experience.

Ulcerative colitis is also a chronic condition. There is no cure unless your child has surgery to remove all of their colon. However, your doctor can help you and your child manage the condition in many ways. Treatments for children are often slightly different from treatments for adults.

An estimated 15 to 20 percent of all Americans with ulcerative colitis are children. Most are diagnosed after the age of 10.

Children with ulcerative colitis can have a variety of symptoms related to inflammation. These symptoms may range from moderate to severe. Children with ulcerative colitis also often go through peaks and valleys of the disease. They may not have symptoms for some time, then they may experience a flare-up of more serious symptoms.

Symptoms may include:

  • anemia due to blood loss
  • diarrhea, which may have some blood in it
  • fatigue
  • malnutrition, because the colon doesn’t absorb nutrients as well
  • rectal bleeding
  • stomach pain
  • unexplained weight loss

Sometimes, a child’s ulcerative colitis may be so severe that it causes other symptoms that don’t seem to be related to the gastrointestinal tract. Examples include:

  • brittle bones
  • eye inflammation
  • joint pain
  • kidney stones
  • liver disorders
  • rashes
  • skin lesions

These symptoms can make ulcerative colitis difficult to diagnose. The symptoms may seem like they are due to a different underlying condition. On top of that, children may have a hard time explaining their symptoms. Adolescents may feel too embarrassed to express their symptoms.

Doctors don’t know exactly what causes ulcerative colitis. Researchers think that in some cases, a virus or bacteria may cause an inflammatory reaction in the colon.

Some risk factors for the condition have been identified, however. One of the main risk factors for ulcerative colitis is having a family member with the disease. According to Seattle Children’s Hospital, an estimated 20 percent of people with ulcerative colitis have a close relative who also has the condition.

There is no one test used to diagnose a child with ulcerative colitis. However, your doctor can do many different tests to rule out other conditions that have symptoms similar to ulcerative colitis.

They will begin by doing a physical exam and taking a health history of your child’s symptoms. They will ask what makes the symptoms worse and better and how long they have been taking place.

Further tests for ulcerative colitis include:

  • blood tests, including checking for low red blood cell levels, which could indicate anemia, and high white blood cell levels, which is a sign of an immune system issue
  • a stool sample to test for the presence of blood, unexpected bacteria, and parasites
  • an upper or lower endoscopy, also known as a colonoscopy, to view or sample the inner portions of the digestive tract to check for signs of inflammation
  • a barium enema, which helps your doctor better view the colon in X-rays and identify possible areas of narrowing or obstruction

Treatment for ulcerative colitis can depend on how severe your child’s symptoms are and what treatments their disease responds to. Ulcerative colitis in adults is usually treated with a special kind of enema that has medication. However, children can’t often tolerate receiving the enema. If they can take medications, some treatments include:

  • aminosalicylates, to reduce inflammation in the colon
  • corticosteroids, to keep the immune system from attacking the colon
  • immunomodulators or TNF-alpha blocking agents, to reduce inflammation reactions in the body

If your child’s symptoms do not respond to these treatments and get worse, your doctor may recommend surgery to remove the affected part of their colon. Your child can live without all or part of their colon, although removal can impact their digestion.

Removing part of the colon does not cure the disease. Ulcerative colitis may reappear in the part of the colon left after surgery. In some circumstances, your doctor may recommend removing all of your child’s colon. A portion of their small intestine will be rerouted through the abdominal wall so stool can exit.

Learn more: Ulcerative colitis treatment options »

An estimated 25 to 30 percent of children with ulcerative colitis will need to be admitted to a hospital. Ulcerative colitis that begins in childhood is also more likely to affect a large portion of the colon. How much of the colon is affected is linked to how serious the disease is.

Having a condition that causes chronic upset stomach and diarrhea can be difficult for a child to understand and experience. In addition to the physical effects, children can have anxiety and social problems related to their condition. According to Children’s National Health System, some of the most common concerns include:

  • frustration with feeling “different” and having physical limitations at times
  • anger about having the condition
  • embarrassment about having to use the bathroom frequently
  • anxiety about weight loss and affected growth
  • peer pressure to eat foods that will worsen their symptoms

There are many ways children and their parents can work to cope with ulcerative colitis and live healthy and happy lives. Try these:

  • Educate loved ones, teachers, and close friends about the disease, nutritional needs, and medications.
  • Seek the advice of a registered dietitian for meal planning to make sure your child is getting enough nutrients.
  • Seek out support groups for people with inflammatory bowel disorders.
  • Talk to a counselor as needed.