teens

Ulcerative Colitis

What Is Ulcerative Colitis?

Ulcerative colitis is a condition that causes the inner lining of the large intestine (colon) to get red and swollen with sores called ulcers. It's a chronic condition, which means it lasts a long time or constantly comes and goes.

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that happens only in the colon.

What Are the Signs & Symptoms of Ulcerative Colitis?

The most common symptoms of ulcerative colitis (pronounced: ko-LYE-tiss) are cramping belly pain and diarrhea. Other symptoms include:

blood in the toilet, on toilet paper, or in the stool (poop)
urgent need to poop
a fever
low energy
weight loss

Ulcerative coliits can cause other problems, such as rashes, eye problems, joint pain and arthritis, and liver disease. Kids with ulcerative colitis may not grow well as well as other kids their age and puberty may happen later than normal.

What Causes Ulcerative Colitis?

The exact cause of ulcerative colitis is not clear. It is probably a combination of genetics, the immune system, and something in the environment that causes inflammation. Diet and stress may make symptoms worse, but probably don't cause ulcerative colitis.

Ulcerative colitis tends to run in families. But not everyone with ulcerative colitis has someone in the family with ulcerative colitis or IBD. Ulcerative colitis can happen at any age, but is usually diagnosed in teens and young adults.

How Is Ulcerative Colitis Diagnosed?

Doctors diagnose ulcerative colitis with a combination of blood tests, stool (poop) tests, and X-rays. They will check stool samples for blood. They also might do imaging tests, such as CT scans and MRI.

Doctors can look at the colon using an endoscope, a long, thin tube with a camera attached to a TV monitor:

In a colonoscopy, the tube goes in through the anus.
In an upper endoscopy, the tube passes down the throat.

The doctor can see inflammation, bleeding, or ulcers in the esophagus, stomach, small intestine and on the wall of the colon. During the procedure, the doctor might do a biopsy, taking small tissue samples for testing in a lab.

How Is Ulcerative Colitis Treated?

Ulcerative colitis is treated with medicines and sometimes surgery. The goal of treatment is to relieve symptoms, prevent other problems, and avoid flare-ups.

Your doctor may recommend:

anti-inflammatory drugs to decrease the inflammation
immunosuppressive agents to prevent the immune system from causing further inflammation
biologic agents to block proteins that cause inflammation

Because some medicines make it harder to fight infections, it's important that you be tested for tuberculosis and have all the recommended vaccines before starting treatment.

Poor appetite, diarrhea, and poor digestion of nutrients can make it hard for teens with ulcerative colitis to get the calories and nutrients the body needs. Be sure to eat a variety of foods, get plenty of fluids, and avoid foods that make your symptoms worse. Some teens may need supplements, like calcium or vitamin D. Someone who isn't growing well may need special drinks or shakes to boost calories and nutrition.

Surgery may be necessary if:

the bowel develops a hole
the bowel widens and swells up (called toxic megacolon)
the bleeding can't be stopped
symptoms don't respond to treatment

What Else Should I Know?

It can be a challenge to deal with the symptoms of ulcerative colitis. But many people with the condition can stay well and have few symptoms for long periods of time. Talk to your doctor about ways you can feel better during flares. Because stress can make symptoms worse, it’s important to get enough sleep and manage stress in positive ways. Yoga, meditation, breathing and relaxation techniques, music, art, dance, writing, or talking to a friend can help.

If you feel sad or anxious about your symptoms, it may also help to talk to a therapist or other mental health professional.

As you get older, you can take on more responsibility for managing your health care. Getting treatment for ulcerative colitis, managing your symptoms, and keeping a positive attitude can help get you back on track.

You also can find more information and support online at:

Medically reviewed by: J. Fernando del Rosario, MD

Date reviewed: January 2022