A Nursing Perspective on Treating Ulcerative Colitis in Children

• Treating ulcerative colitis presents a challenge in pediatric patients due to its impact on growth, development, and psychosocial well-being.  
• Pediatric patients may also experience growth failure and delayed puberty, which complicates their medical and emotional needs.  
• Nurses provide vital emotional and physical support for patients and their families.  

Ulcerative colitis (UC) — a chronic inflammatory bowel disease (IBD) that affects the lining of the colon and the rectum — poses a notable challenge in pediatric patients due to its impact on growth, development, and psychosocial well-being.  

As nurses, our goal is to manage the complexities of UC and provide holistic care to patients and their families. This article highlights critical aspects of UC nursing care, emphasizing education, emotional support, and individualized care. 

Treating Ulcerative Colitis 

UC typically presents with abdominal pain, bloody diarrhea, fatigue, weight loss, and anemia. Pediatric patients may also experience growth failure and delayed puberty, which complicates their medical and emotional needs. The goals of UC management are controlling inflammation of the intestine, promoting remission, ensuring adequate nutrition, and maintaining quality of life.  

Nurses should regularly monitor (and thoroughly document) signs of dehydration, especially during UC flares, as diarrhea can lead to fluid and electrolyte imbalances. Monitoring daily weights and developmental milestones can help identify growth delays or nutritional deficiencies.  

Nutrition 

The interdisciplinary team should include nurses and dietitians to develop a diet plan tailored to your patient’s needs. If a flare up causes severe symptoms, your patient might need complete bowel rest, requiring total parenteral nutrition (TPN) and lipid therapy.  

After a patient is on bowel rest, reintroduced food and drink slowly, starting with clear liquids, then full liquids, and then a bland or regular diet. When the patient can resume a regular diet, the nurse or dietician should instruct them to eat small, frequent meals and make sure they understand what triggers their symptoms, such as spicy foods or dairy. Documenting food intake and any related symptoms in a journal can help.

Emotional support 

Nurses should actively support and encourage patients. This can be accomplished through positive reinforcement and praise for achievements.

You can also connect patients with support groups or other families undergoing similar challenges to help them feel less isolated. And don’t be afraid to teach or suggest relaxation techniques, journaling, nonpharmacological pain control, and other creative outlets to manage stress. 

Throughout this aspect of care, assess the patient’s mental health and inform the physician if you see a need for a visit with a psychiatrist or mental health counselor. Chronic illnesses, as you know, can cause anxiety, depression, and body image issues.  

Prioritize collaboration 

Nurses should prioritize collaboration with child-life specialists to provide comprehensive and age-appropriate educational resources about the disease. This includes disease management, identifying symptoms, and understanding treatment options.  

Patients and their families need to know how to recognize early signs of a flare-up and be able to develop a clear plan for symptom management, including when to seek medical assistance. 

Maintaining daily routines

Nurses assist patients in maintaining their daily routines. To promote a sense of normalcy, encourage your patients to work on school assignments while hospitalized. This helps them stay connected to their academic responsibilities and provides a sense of purpose. 

Additionally, nurses should facilitate participation in physical activities tailored to each patient’s energy levels. Depending on their condition, this could involve gentle exercises, guided stretches, or even short walks. Engaging in physical activity is important for recovery and helps boost mood and confidence. 

Medication management 

Various medications, according to Yale Medicine, help manage UC, including: 

• Aminosalicylates: reduce inflammation in intestinal lining 
• Steroids and immunosuppressants: slow disease progression 
• Immunomodulatory treatments: control and suppress the immune system to reduce inflammation. May be used alongside biologics, medications blocking proteins contributing to inflammation.  
• Infusion therapy: delivers medication directly into the body through blood vessels, muscle, or spinal cord. 
• Infliximab: binds to and inhibits the activity of a specific protein known to cause inflammation.  

Nurses should educate patients and families about medication adherence to the prescribed regimens and any potential side effects of the medications. Nurses should monitor for adverse effects, especially if it is the patient’s first dose.  

The Bottom Line

Treating ulcerative colitis in pediatric patients requires a thorough and compassionate approach that addresses multiple aspects of their well-being. This includes medical management to control symptoms and prevent flare-ups, tailored nutritional support, and emotional care. Equipping young patients and their families with knowledge about UC empowers patients to make informed decisions about their care.  

As nurses, we possess the advocacy, empathy, and specialized knowledge needed to make a significant positive impact in the lives of these children and their families. By embracing a holistic care philosophy, we can foster resilience and help pediatric patients with UC truly thrive. 

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