What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease or IBD refers to chronic inflammation of the bowel.  In general, there are 2 types of Inflammatory bowel disease: Crohn’s disease (CD) and Ulcerative Colitis (UC). IBD is not the same as IBS (Irritable Bowel Syndrome) which is a benign functional bowel condition nor is it infectious. Approximately 30% of IBD presents during childhood and adolescence.

What is Ulcerative Colitis?

Ulcerative Colitis (UC) is a type of IBD involving mainly the large bowel also known as the colon. In UC, the inner lining of the colon becomes inflamed resulting in many tiny ulcers developing on its surface.

What Causes Ulcerative Colitis?

Ulcerative Colitis is a form of autoimmune disease when the body’s own immune fighting system starts attacking healthy cells. The exact cause of the disease is unknown. It is thought to be caused by a combination of both genetic and environmental factors which lead to activation of the immune system causing injury to the lining of the intestine. The inflammation further leads to ulcers and bleeding.

What are the signs and symptoms of Ulcerative Colitis?

• Tummy pain
• Diarrhoea often with blood in the stool
• Weight loss or poor growth
• Fatigue/Decreased energy level
• Loss of appetite
• Unexplained fevers, joint pains, or rashes
• Anaemia (low red blood cell count)

How is Ulcerative Colitis diagnosed?

If you are worried that your child may have Inflammatory Bowel disease or ulcerative colitis, he or she should see a paediatric gastroenterologist early for further workup.

Following a thorough medical history and physical examination, your doctor will order blood tests, stool tests and/or imaging studies. An upper endoscopy and colonoscopy will be performed by the paediatric gastroenterologist to confirm the diagnosis and evaluate the severity of the disease.

How is Ulcerative Colitis in children treated?

In general, medications for treatment of Ulcerative colitis are divided into 2 categories. The first category is drugs used to control the disease. The second category of medications helps keep the symptoms from starting or coming back. Your child might have to take a combination of medication to control his condition.

Frequent diarrhoea might affect your child’s body ability to absorb sufficient nutrients from food. Your doctor might prescribe vitamins and other supplements together with the rest of the medications.

What about the long term and cancer risk?

The goal in our treatment of Ulcerative Colitis is to enable the child to lead as normal a life as possible.  It is likely that he or she will need to continue with long term medications with regular visits to the doctor. However, if the disease is well controlled, treatment can be maintained without further escalation.

There is an increased risk of colon cancer after 8 years of diagnosis of Ulcerative Colitis especially in those with poorly controlled disease. It is recommended that patients with Ulcerative Colitis get a screening colonoscopy every 1 or 2 years after eight years of diagnosis. The paediatric gastroenterologist can look for cancer and treat if they find it.