What is ulcerative colitis?

Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the large intestine, or colon. It usually affects the lower section and the rectum. But it can affect the entire colon. In general, the more of the colon that's affected, the worse the symptoms will be.

The main symptoms of ulcerative colitis are:

• Belly pain or cramps.
• Diarrhea.
• Bleeding from the rectum.

Some people also may have a fever, may not feel hungry, and may lose weight. In severe cases, people may have diarrhea 10 to 20 times a day.

The disease can also cause other problems, such as joint pain, eye problems, skin problems, or liver disease.

In most people, the symptoms come and go. Some people go for months or years without symptoms (remission) and then have a flare-up. A few people have symptoms all the time.

To diagnose ulcerative colitis, a doctor will ask about your symptoms, do a physical exam, and do a number of tests. Testing can help rule out other problems that can cause similar symptoms, such as Crohn's disease and irritable bowel syndrome.

Tests that may be done include:

• Colonoscopy. In this test, a doctor uses a thin, lighted tool to look at the inside of your entire colon. At the same time, the doctor may take a sample (biopsy) of the lining of the colon.
• Blood tests to check for infection or inflammation.
• Stool sample testing to look for blood, infection, and white blood cells.

Treatment is done to improve your symptoms and to heal your colon. Treatment depends on:

• How bad the disease is.
• What treatments have worked.
• Your age.
• If you have certain infections, such as Clostridioides difficile (or C. diff).

Medicines.

• For mild or moderate cases of the disease when there is little risk of needing surgery, most people can be treated with pills or rectal medicines. These medicines reduce inflammation and calm down the immune system. Some people need steroid medicines.
• For moderate or severe cases of the disease when there is a high risk of needing surgery, medicines (such as biologics) are used to prevent inflammation. These are given intravenously (I.V.) or as a shot. Other medicines to calm down the immune system may be needed. Some people need steroid medicines.

Surgery.

You might need surgery to remove the colon:

• If it's an emergency, such as a problem like toxic megacolon.
• If medicines don't help your symptoms, or if side effects are causing problems.

Surgery almost completely reduces the risk of colon cancer.

• Call your doctor if you think your child is having a problem with a medicine.
• Do not give your child anti-inflammatory medicines unless the doctor says it is okay. These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). They may make symptoms worse.
• Talk to your doctor before you give your child any other medicines or herbal products.
• Make sure your child eats enough protein and drinks plenty of fluids. During a flare-up, avoid foods that make your child's symptoms worse. This may include foods that are high in fiber or high in fat. It may also include foods and drinks that have lactose, like dairy products.
• Talk to a dietitian to make sure your child is getting the nutrition, including vitamins and minerals, that they need.