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Does my 3-year-old son have UC?

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Ulcerative Colitis
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Posted 7/25/2012 12:43 AM (GMT 0)
Hello, I was wondering if anyone could help me. My son is 3 years old (almost 4) and has had digestive issues since he was a baby. He is very undersized, both in height and weight (under 5th percentile, just about off the charts). He will go days without eating solid food and always prefers eating liquids to solids. He rarely has diarrhea but frequently has rectal bleeding, sometimes in large amounts. He has "flare-ups" when his symptoms all occur at the same time (along with heel pain, which is always present in these flare-ups), and then may go weeks with no symptoms.

My son has had a colonoscopy and an upper endoscopy, which found nothing wrong with him. Every blood test (CBC, blood count, SED rate, CRP, food allergies) has come back normal too. However, none of these tests has taken place during a flare-up.

I have Crohn's Disease but no other family members have IBD. Does it sound like UC, perhaps only affecting the rectum? I know my son is young for it but it is possible. What were your symptoms when you were young and first started having symptoms?
Posted 7/25/2012 1:26 AM (GMT 0)
I don't think anyone can tell you whether he has UC but his symptoms certainly could indicate UC. It's wonderful that you've been so active in finding answers, and being that you have Crohn's, you know what to look for. The fact that the colonoscopy showed nothing is great news. At this point, I don't know what you can do besides wait and see. Next time he has blood in his stool, you should see if you can get him in for a flex sig. That will tell whether you're dealing with inflammation in the rectum as you suspect it may be. My symptoms did start off with mostly bleeding. I didn't have much pain or frequency, no urgency. I didn't have those types of symptoms until my UC had progressed to pancolitis. It is possible that he is dealing with something completely different. In an adult, I would suspect a fissure or hemmie but that wouldn't be likely at all in a toddler. Poor little guy. I hope it's not UC and it's something easy to treat. Perhaps he has a bug of some kind? have you done stool tests? Is the blood bright red?
Posted 7/25/2012 1:48 AM (GMT 0)
If you have Crohn's, and your son's scopes are showing no inflammation, why are you focused on UC? Shouldn't you and ped GI be talking about the possibility of Crohn's in the small bowel?

The kind of inflammation that UC and Crohn's cause is not a fleeting thing, that you won't see during a quiescent time and then suddenly pops up during a flare. You didn't say what the time frame is between the flares you're describing, but I'm guessing that they aren't spaced apart by years since he's only 3.

Has the ped GI talked to you about constipation? Are your son's stools hard? This can obviously cause rectal bleeding. How frequent are his bowel movements?
Posted 7/25/2012 2:42 AM (GMT 0)
bania, maybe keep a food diary of what he eats every day and see if something keeps coming up when the bleeding is there.

when i was a baby, my mom realized right away that i had a problem with dairy formula because i was always very gasy and coughing all the time. she switched to soy formula and it was all better.

does he strain when he goes to the bathroom? this can definitely cause bleeding and hemmies, too.
Posted 7/25/2012 11:48 AM (GMT 0)
If there's no visable signs of UC then I think you can rule that out.

IF its digestive issues I believe your son probably has bad intestinal flora.
Unfortunately there's no place in the world that can test intestinal flora to
determine if that is the problem.
They can test stool for all known parasites, pathogens, etc.
With all the tests performed I believe this test should be performed also.
Posted 7/25/2012 2:17 PM (GMT 0)
Thank you all for your responses so far. You are bringing up good points.

To answer your questions, the blood is bright red, leading his GI to believe it is coming from the rectum or lower colon, and not the small intestine. His GI has of course discussed Crohn's, since I have it, but the symptoms don't match up - no stomach pain, no diarrhea, bright red blood. Sometimes he has constipation issues, but there is no correlation between the bleeding and the type of stool. Sometimes it happens when he's straining, and sometimes it happens with loose stool. He's had testing done for all sorts of food allergies and Celiac, and all came back negative. We've kept food diaries, eliminated common allergens, etc. and nothing stood out. We have prescriptions for the stool tests (for parasites and others) but haven't done them yet.
Posted 7/25/2012 2:51 PM (GMT 0)
Bania, my daughter sometimes passes blood with her stool, and she has insisted for a long time that she is not constipated. She moves her bowels about every day. When her ped GI showed her the pediatric Bristol scale of stool hardness she identified her stool as being mostly of the "2" variety, which is pretty hard. Her GI has recommended that she use a stool softener (miralax) for a while to see if that resolves the blood. Maybe that's something to think about for your son, too.
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