What is Ulcerative Colitis?
Ulcerative colitis (UC) is an autoimmune disease and chronic condition. It causes inflammation of the large intestines (colon and rectum). In UC, your immune system mistakenly attacks healthy intestinal tissues in the intestines. Even though UC often causes severe diarrhea, it is not contagious.
UC is part of a group of diseases called inflammatory bowel diseases (IBDs) which are all affecting the intestinal tract and causing inflammation.
Types of IBD
Ulcerative Colitis (UC)
- Affects only the large intestines.
- Causes continuous inflammation of the intestines.
- Inflammation is visible during colonoscopy.
- Affects only the inner layer of the colon.
Crohn’s Disease (CD)
- Can affect any part of the gastrointestinal tract (from the mouth to the rectum).
- Causes patchy inflammation.
- Inflammation visible during gastroscopy and/or colonoscopy.
- Affects all layers of tissue in the inflamed area.
- Often impacts terminal ileum and parts of the colon.
Unclassified IBD
- In few cases, it is initially impossible to categorize symptoms and diagnostic findings into UC or CD.
Microscopic Colitis
- Affects only the large intestines.
- Causes patchy inflammation.
- Inflammation is not visible during gastroscopy or colonoscopy, only under a microscope.
- Leads to frequent and watery diarrhea, but not bloody like in UC or CD.
- More common in adults, especially older adults.
IBDs are on the rise worldwide. It’s estimated that between 2.4 and 3.1 million people in the United States have some type of IBD.
IBDs in children and adolescents tend to be more severe than in adults. This often means more widespread inflammation, more complications, and a higher risk of developing pancolitis, which affects all parts of the large intestines (ascending colon, transverse colon, descending colon, sigmoid colon, and rectum).
Don’t confuse IBDs with IBS (irritable bowel syndrome)
- IBS don’t involve inflammation of the intestines.
- IBS usually cause alternating constipation and diarrhea.
- IBS underlying issue is an increased sensitivity of the nerves and muscles that transport food through the gastrointestinal tract.
Comorbidity
Living with a chronic condition like UC isn’t easy, and teens with an IBD are more likely to face mental health challenges like anxiety or depression. Everyone’s experience is different though — the challenges below are possible, not expected. Some teens face none, others a few.
Mental Health Challenges
- Its unpredictability
- Embarrassing symptoms
- Complex and demanding treatment and frequent doctor appointments
- Limitations due to treatment or side effects
- Constant threat of flare-ups
Impact on Identity
- Low self-esteem
- Low self-confidence
- Difficulties socializing with peers
- Delays in emotional maturity and independence due to the need of extra support from parents or caregivers
Other Health Problems
- Growth delays
- Delayed puberty
- Poor weight gain
- Osteoporosis
- Arthritis
- Skin problems like erythema nodosum
- Eye diseases like uveitis
What’s Next
Good management means understanding your symptoms, knowing your medication, and keeping regular monitoring appointments like blood work or stool tests. Without consistent treatment and follow up, the risk of complications and hospital stays increases.
Many people with ulcerative colitis stay well when the disease is managed properly, but complications can occur in some cases.
Possible Complications
Most of these are rare and preventable with good care — the list below is here so you know what to watch for, not to worry about.
Complications can include severe bleeding and anemia, dehydration, inflammation of skin, joints, or eyes, osteoporosis (linked to long-term use of corticosteroids), abscesses, strictures, or fistulas, stoma surgery in very severe cases (rare in pediatric Crohn’s disease), toxic megacolon, colon perforation, primary sclerosing cholangitis, and an increased risk of colorectal cancer (depending on the extent and duration of the disease).
As you approach adulthood, make sure to discuss and plan a smooth transition from your pediatric medical team to an adult care team, usually between the ages 18 and 21.
Want a quick recap? → Explore: Ulcerative Colitis has myths and facts around diabetes, symptom explorer, flashcards, quizzes, transition and travel checklists, and much more.