Ulcerative Colitis

Alternative names: nonspecific ulcerative colitis  

Definition: A chronic, episodic, inflammatory disease of the large intestine and rectum characterized by bloody diarrhea.  

Causes, incidence, and risk factors: The cause is unknown, and it may affect any age group although there are peaks at ages 15 to 30 and then again at ages 50 to 70. The disease usually begins in the rectal area and may eventually extend through the entire large bowel.  

Repeated episodes of inflammation lead to thickening of the wall of the intestine and rectum with scar tissue. Death of colon tissue or sepsis may occur with severe disease. The symptoms vary in severity and their onset may be gradual or sudden. Attacks may be provoked by many factors, including respiratory infections or stress.  

Risk factors include a family history of ulcerative colitis or Jewish ancestry. The incidence is 5 out of 10,000 people.  

Symptoms:

  • diarrhea of between 10 and 25 times a day, blood and pus may be present
  • abdominal pain and cramping that usually subsides after a bowel movement
  • abdominal sounds (borborygmus, a gurgling or splashing sound heard over the intestine)
  • fever
  • weight loss
  • stools - foul smelling
  • tenesmus

Additional symptoms that may be associated with this disease:

  • nausea & vomiting
  • joint pain
  • gastrointestinal bleeding

Signs and tests:

  • colonoscopy with biopsy
  • barium enema

This disease may also alter the results of the following tests:

  • serum magnesium - test
  • haptoglobin
  • complement component 3
  • complement
  • CEA

Treatment: The goals of treatment are to control the acute attacks, prevent recurrent attacks, and promote healing of the colon. Hospitalization is often required for severe attacks. Corticosteroids are prescribed to reduce inflammation. Sulfasalazine may decrease the frequency of attacks. Surgery may be indicated in refractory disease.

Since the incidence of malignancy increases over time, most patients undergo total colectomy with ileonectal deconstruction.

Expectations (prognosis): The course of the disease varies with remissions and exacerbations over a period of years, or the disorder can present as a fulminant disease. The risk of cancer increases in each decade after the diagnosis. Total colectomy is curative.

Complications:

  • perforation of the colon
  • carcinoma
  • massive colonic hemorrhage
  • inflammation of the joints
  • ankylosing spondylitis
  • lesions in the eye
  • mouth ulcers
  • liver disease
  • impaired growth and sexual development in children
  • pyoderma gangrenosum

As with any procedure we perform, your child's safety and well-being our #1 priority.  As always, feel free to contact us with any question that you have.  We would be happy to answer it for you.