Fifteen percent of patients with this disease present as children between the ages of 10-16. The most common clinical pattern in children is intermittent acute colitis with interval remissions that causes mucous diarrhea, colicky abdominal pain, melena and tenesmus. Liver disease and arthritis may be seen as extracolonic manifestations. Systemic symptoms include anemia, anorexia, nutritional deficiency, and electrolyte imbalance. Colon cancer develops more frequently in cases that present early.
Etiology is ill defined.
First a nonspecific inflammation of the mucosa and submucosa is seen followed by widespread superficial ulceration, then muscular and serosal involvement leading to a rigid short colon is seen. Usually involves the total colon, beginning in the rectum and proceeding in a retrograde fashion. Has symmetrical and contiguous colon involvement without skip lesions as are seen in Crohn's Disease. On double contrast barium enema acutely finely spiculated mucosal ulcers with variable edema and normal haustra are seen. With advancing disease, more prominent ulcers are seen that form a serrated mucosal contour.