Ulcerative Colitis is an inflammation of the lining of the large intestine (colon). This begins in the rectum and can be found continuously involving areas of the colon up to the entire colon.

The inflammation causes diarrhea and urgency of needing a stool as the cells on the surface of the lining of the colon lose their ability to do their job (absorbing water and holding waste). As they die off and are injured, open sores occur which cause ulcers to form. This causes mucus and blood in the stools.

Each case is different, but the most common symptoms include:

• Abdominal pain
• Bloody diarrhea
• Urgency of needing to stool
• Fatigue
• Weight loss
• Loss of appetite, nausea and/or vomiting
• Rectal bleeding
• Loss of body fluids and nutrients
• Anemia caused by severe bleeding

The symptoms of Ulcerative Colitis may be similar to other IBDs, like Crohn’s disease. Your child will need testing to be certain of their diagnosis.

Ulcerative Colitis Testing

Our team will work with your family to make sure your child has the correct diagnosis. This helps us form the best care plan for them.

Common tests to diagnose Ulcerative Colitis include:

• Blood tests: To check for anemia and iron deficiency from blood loss and signs of inflammation
• Stool tests: Checks for inflammation, blood loss and infections
• Endoscopy: The doctor uses a small, flexible tube with a light and a camera at the end called an endoscope. Once your child is given anesthesia and comfortably asleep, the scope goes into the mouth to see the inside of the digestive tract from the upper end. They can also take tissue samples, called a pinch biopsy, for testing to determine what type of inflammation is happening.
• MRI Enterography (MRE): Contrast is given to show the small bowel to determine if there is inflammation in areas that cannot be seen by the traditional endoscopic approaches. This is done without radiation, and an also show the structure of the liver as well as whether there is inflammation around the rectum in patients presenting with abscesses in those areas.
• Colonoscopy: Like an upper endoscopy, a think, flexible tube with a camera is used to look at the inside of your child's colon and last part of the small bowel. The doctor can take a pinch biopsy to look for signs of inflammation.

We create an Ulcerative Colitis care plan for your child based on a number of factors. These include their:

• Age
• Level and location of inflammation
• Overall nutrition status and health
• Medical history
• Appropriateness and tolerance for certain treatments 

Common Ulcerative Colitis treatments include:

• Medicines: Anti-inflammatory medicine can reduce the level of impact of inflammation on the areas of the colon which cause the symptoms in Ulcerative Colitis like cramps and diarrhea. More serious cases may require medications like steroids, oral anti-inflammatory medications and injectable or intravenous medications targeted specifically at certain signals the body creates to result in the inflammatory response.
• A hospital stay: Children with severe symptoms may become malnourished. A hospital stay can get them on a special diet or get nutrients in an IV. Treatment can help stop diarrhea and blood loss. Your child will also have access to surgeons if they need an operation.
• Surgery: Most children with Ulcerative Colitis do not need surgery. Our team works together to approach each child's case to optimize timing of surgery and to coordinate things like nutrition and timing of medicine changes if needed. Ultimately, surgery is one of our tools to treat our patients when complications occur from damage from disease or when medications are not working.

Our team gives you and your family the best and safest care possible. We provide a comfortable and welcoming place during every step of your journey. We’re here for you, from initial diagnosis to long-term management.

Deciding where to seek treatment for your child's GI issues can be difficult and stressful. The range of options, including new and experimental treatments, can be hard to figure out. We want to make it as easy as we can.

In addition to world-class care, we provide many resources for kids and their families. We want your journey to be as smooth as possible, given the difficult circumstances.

Before Your First Visit

For your first visit to the IBD Program, you may be asked to provide:

• Your child’s medical history
• Past test results
• List of medicines
• Reports from previous procedures

If you have any questions before our first meeting, please contact our team.

During Treatment

Your care team creates a welcoming, familiar, healing place for your family. We know that each child with Ulcerative Colitis needs a unique care plan. We will work with you to figure out the best care options for your child.

Depending on your care plan, we may work with other highly skilled experts across Children’s Wisconsin. We take great pride in providing the very best care for your child. Our approach to IBD care includes:

• A pediatric gastroenterologist and expert in IBD. They’ve cared for many difficult or unique cases.
• A pediatric nursing staff with extensive knowledge of Ulcerative Colitis and its care.
• A registered pediatric dietitian who manages your child’s diet and nutrition while considering the impact on their Ulcerative Colitis.
• An IBD psychologist who focuses on care for kids with Inflammatory Bowel Disease and other chronic diseases.
• Pediatric surgeons who are experts in complex IBD surgery, including less invasive methods such as robotic surgery.
• Social workers who can assist with the financial challenges of care. 

After Care

Care for Ulcerative Colitis is lifelong. It requires long-term medical care.

The goal is to keep your child in remission which means that the disease is not active and symptoms go away. Remission is aimed to last for months or even years. There is no way to predict when remission may occur or when symptoms will return. However, in Ulcerative Colitis, symptoms usually come back and changes may be needed to control disease or symptoms.

We’ll be here for continued monitoring, help during flare-ups, consideration of new medicines and treatments to try and long-term care. You can always contact our team if you have any questions.