Bloody diarrhea with mucus is the most typical first symptom of ulcerative colitis. The generalized or systemic signs of anorexia, weight loss, and growth failure may be present, these are more typical of Crohn disease. Ulcerative colitis is characterized by unpredictable flareups. It usually may be quieted with medications, but eventually it recurs. Occasionally, the colitis becomes intractable and may then require surgical treatment.
Treatment is aimed at controlling symptoms and reducing the risk of recurrence.
It has been used extensively over many years, and its effects and side effects are well known. It is the only drug known to prevent relapses. Children with moderate to severe colitis or colitis who do not improve with 5-aminosalicylate therapy are treated with corticosteroids, usually prednisone. Cases that are especially severe and resistant to drug therapy sometimes require surgical removal of the colon. After about the first ten years of the disease, the risk of colon cancer begins to increase rapidly for ulcerative colitis patients.