COLITIS, ULCERATIVE |
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DESCRIPTIONUlcerative colitis is a serious chronic inflammatory disease of the colon characterized by ulceration and episodes of bloody diarrhea. The ulcerated areas are inflamed and may form abscesses in the lining of the large intestine. The rectum and large bowel are involved. Ulcerative colitis is most common in females and is unusual before puberty.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Psychological counseling.
Surgery to remove the diseased colon (sometimes). For an explanation of this surgery and postoperative care, see ileostomy in the Glossary.
Hospitalization during worst episodes.
SIGNS & SYMPTOMS
Early symptoms include:
Pain in the left side of the child's abdomen that improves after bowel movements.
Episodes of bloody diarrhea with mucus, alternating with symptom-free intervals.
During an acute attack:
Increased bloody diarrhea (up to 10 to 20 bowel movements a day).
Severe cramps and pain around the rectum.
Sweating.
Nausea.
Loss of appetite and weight loss.
Bloated abdomen.
Fever as high as 104F (40C).
CAUSES
Unknown.
RISK FACTORS
Stress, anxiety or depression.
Family history of ulcerative colitis.
Excess alcohol consumption.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory stool and blood studies.
X-ray of the colon (barium enema).
Sigmoidoscopy (See Glossary).
POSSIBLE COMPLICATIONS
Life-threatening blood loss, ulceration through the intestinal wall, or peritonitis during acute attacks.
Malnutrition, wasting of the child's body, or chronic disability.
Inflammation of joints, eyes, and skin.
Colon cancer. The risk is greater in persons with ulcerative colitis.
PROBABLE OUTCOME
Often curable with counseling and medical treatment or surgery. If not curable, the child's symptoms can be controlled with treatment.
TREATMENT
HOME CARE
To reduce your child's cramps, apply a hot-water bottle, warm moist towels or heating pad to the abdomen.
Try to reduce your child's stress. See Appendix 19.
MEDICATION
Don't use aspirin. It increases the bleeding risk.
Your doctor may prescribe:
-- Anti-diarrhea medication for minimal symptoms.
-- Sulfa drugs, such as sulfasalazine, for moderate symptoms.
-- Cortisone drugs for severe disease.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Bed rest may be necessary during an acute attack. However, your child can resume normal activity as soon as symptoms improve.
DIET & FLUIDS
Urge your child not to drink alcohol.
During early treatment, the child should avoid milk and milk products.
OK TO GO TO SCHOOL?When weight loss ceases, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of ulcerative colitis.
Fever and chills develop.
Frequency of bowel movements or bleeding increases.
Abdomen becomes distended.
Jaundice (yellow eyes and skin and dark urine) develops.
Vomiting begins or abdominal pain increases.
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