An inflammatory disease, colitis affects the colon (large intestine), the lower portion of the digestive tract, which leads to the rectum. This inflammation can lead to formation of ulcers in the mucous membrane lining the colon, creating the potential for bleeding, intestinal perforation, and a life-threatening infection called peritonitis.

HOW DOES COLITIS DEVELOP?
In children, the most common cause of colitis is bacterial infection with organisms such as shigella. Other types of colitis that may affect children are ulcerative colitis and Crohn's disease. These conditions develop for reasons that are not fully understood, and they may recur throughout life.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS COLITIS?
The hallmark of colitis is loose bowel movements containing mucus, pus or blood. Abdominal cramps usually accompany this symptom. The bowel movements come on with great urgency, and may occur several times a day. Other signs to look for are abdominal bloating and rumbling. In ulcerative colitis and Crohn's disease, weight loss and poor growth may occur over time. Nausea, vomiting, and fever are often present in a bacterial colitis.

The frequent diarrhea of colitis has secondary effects to watch out for. If the stool is very bloody, the child may suffer from blood loss or anemia. Dehydration may also develop.

IS MEDICAL ATTENTION NECESSARY?
Yes. Blood in the stool is a serious sign that should always be brought to a doctor's attention.

HOW CAN A DOCTOR TELL IF MY CHILD HAS COLITIS?
The workup starts with a careful medical history and physical exam. A pediatric gastroenterologist, who specializes in digestive disorders among youngsters, may examine the colon and rectum with an instrument called a colonoscope. During colonoscopy, a small sample of tissue (a biopsy) may be removed from the lining of the colon and examined microscopically for changes that suggest colitis. A culture of the stool to search for bacteria or other pathogens that cause colitis will also be done.

WHAT TREATMENTS ARE AVAILABLE?
Colitis resulting from bacterial infection (dysentery) will be treated with appropriate antibiotics. Ulcerative colitis, believed to be an autoimmune disease, is a chronic illness and will be treated differently from infectious colitis.

Mild ulcerative colitis or Crohn's disease, which consists of intermittent bouts of cramps, diarrhea and possible weight loss, may be treated by the physician at home with rest and medication, which may include a sulfa drug (sulfasalazine), corticosteroids or other anti-inflammatory drugs. The child should avoid milk and milk products and high-fiber foods, which can contribute to diarrhea. A hot water bottle may alleviate the cramps.

In moderate and severe ulcerative colitis or Crohn's disease, hospitalization is necessary. The child is lethargic, with weight loss and poor appetite. In the hospital, the child is fed intravenously and given appropriate drug treatment. In very rare cases, if bleeding persists, part of the colon may have to be removed.

GETTING HELP
Call your doctor if:

• Your child's bowel movement contains blood

• Symptoms of diarrhea and cramps occur repeatedly

• Your child is tired and is losing weight

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.