Pancolitis is a form of ulcerative colitis that affects the entire large intestine or bowel. It is a type of inflammatory bowel disease (IBD) with wide ranging symptoms, such as diarrhea, abdominal cramping, and fever.
The full name of pancolitis is pan-ulcerative colitis. Some people also call it total colitis or universal colitis.
It is a chronic condition, meaning it develops over a long period, and there is currently no known cure. Medical and lifestyle remedies can help manage it.
Fast facts on pancolitis:
- Experts do not know what causes pancolitis.
- Some people go for long periods with very few or mild symptoms.
- Other people find the condition has a significant impact on their lives.
Keep reading to learn more about pancolitis, including symptoms, causes, and how doctors diagnose and treat the condition.
Illustration by Yaja’ Mulcare
Ulcerative colitis (UC) is a chronic autoimmune disease that affects the colon. At the end of the colon is the rectum, which stores feces before it leaves the body. In UC, small ulcers can develop on the colon, producing pus and mucus. In turn, this can lead to abdominal discomfort, diarrhea, and rectal bleeding.
A doctor will diagnose a person with pancolitis when the inflammation covers the entire colon.
A 2020 study on the incidence rates of UC in Latin America found, that across 19 studies, around 12 to 64% of people had pancolitis.
Other types of UC include:
Learn more about proctitis vs. ulcerative colitis.
The symptoms of pancolitis are the same as those of UC. According to the UK’s National Health Service (NHS), these include:
- recurring diarrhea, which can contain blood, mucus, or pus
- abdominal pain and cramps
- an urgent need to empty the bowels
Other typical symptoms include:
- tenesmus, which is the need to pass stools even when there is nothing in the bowel
- fatigue, or extreme tiredness
- weight loss
- loss of appetite
- fever
- night sweats
Learn more about the symptoms, signs, and stages of UC.
Flare-ups
A flare-up or relapse is when symptoms suddenly return after a person has not experienced symptoms for a significant period.
During a flare-up, a person can also experience symptoms elsewhere in the body:
- painful and swollen joints
- ulcers in the mouth
- red, painful, and swollen skin
- irritated and red eyes
- shortness of breath
- fast or irregular heartbeat
- high temperature
- bloody stools
Learn more about UC flares and how to manage them.
Pancolitis is a subtype of UC, which is an inflammatory bowel disease (IBD). It is an autoimmune condition, meaning that the immune system attacks healthy tissue instead of defending the body against infection.
Scientists do not know the exact cause of UC but think it develops due to a combination of factors, including:
- a genetic predisposition, meaning something the person is born with
- an atypical reaction from the digestive system to bacteria in the intestine
- unknown triggers, such as viruses, bacteria, stress, or diet
- an atypical immune response
People of any age can develop pancolitis, but doctors more commonly diagnose it in those ages 15 to 25 years.
Gender does not affect how likely a person is to develop the condition.
Learn more about UC and genetics.
When diagnosing pancolitis, the doctor will ask the individual about their symptoms, general health, and medical history.
The doctor might also conduct a physical examination. This may involve them taking stool and blood samples to check for signs of infection and inflammation, among other things.
If the doctor is concerned that a person may have any form of IBD, they may refer them for further tests,
- Blood tests: These can help when looking for cell counts and inflammatory markers.
- X-ray or CT scan: If there are other concerning signs or symptoms, these can help rule out serious complications within the abdomen.
- Colonoscopy: In this procedure, the technician uses a flexible tube containing a camera, called a colonoscope, to examine the colon. During a colonoscopy, the surgeon may take a biopsy. The colon needs emptying before a colonoscopy. The procedure takes around 30 minutes and may be uncomfortable.
Treatment for pancolitis will depend on the severity of the condition and how the symptoms affect the person’s life.
While there is currently no known cure, treatment aims
The two types of treatment currently available are medication and surgery.
Learn about the latest research updates for treating UC.
Medication
The four main forms of medications doctors may prescribe are:
- Aminosalicylates can help reduce inflammation. They come as tablets, capsules, or suppositories for the rectum. A person can also receive them through an enema. Doctors prescribe them for mild to moderate cases, and they rarely have side effects.
- Corticosteroids also reduce inflammation. These are safe to administer orally, as a suppository, or through an enema. However, corticosteroids can cause serious side effects, such as osteoporosis and cataracts, so doctors do not typically prescribe them as a long-term treatment.
- Immunomodulators can help reduce the activity of the immune system. They can be taken as a tablet to treat mild to moderate flare-ups. Immunomodulators can make some people vulnerable to infection and prone to anemia.
- Biologics target specific components of the immune system involved in inflammation. People take biologics via an IV injection or infusion.
Newer oral therapies are available for UC. These include medications called JAK inhibitors (Rinvoq, Xeljanz) and sphingosine 1 phosphate receptor modulators (Zeposia, Velsipity).
Learn about the latest treatments for UC.
Surgery
If flare-ups are having a significant impact on a person’s quality of life or the condition is not responding to medications, then surgery is an option.
Surgery usually involves the complete removal of the colon, which means UC will not return.
However, anyone thinking about having this surgery must consider the consequences.
Once the surgeon has removed the colon, waste must leave the body from the small intestine via a hole in the abdomen. The waste passes into a special bag outside the body. This is known as an ileostomy.
A person may be able to have a second surgery at a later time to create an internal pouch, called an ileoanal pouch. This pouch connects the small intestine to the anus, allowing stools to pass in a more usual way.
Learn more about surgery for UC.
Natural remedies
There are some natural remedies a person can try for symptom relief. These include:
- probiotics, which may help improve the microbiome in the gut
- herbal medicines
such as aloe vera, wheatgrass juice, and others - hydration through drinking plenty of water or an electrolyte solution
- nutritional supplements, which can help replenish lost nutrients
- eating small meals
A person should talk with a doctor before trying any of these remedies.
Learn more about natural remedies for managing UC.
Some serious complications associated with pancolitis include:
- Cancer: The longer a person has had pancolitis, the greater their risk of developing bowel cancer.
- Toxic megacolon: This is when the inflammation is very severe, and the colon dilates in size. Symptoms include fever, abdominal pain, dehydration, malnutrition, and colonic rupture. Toxic megacolon is a medical emergency.
- Anemia: This describes a lack of iron in the blood.
- Fulminant colitis: This is a rare and severe form of pancolitis. Symptoms include dehydration, severe abdominal pain, diarrhea with blood, and shock.
- Perforation of the bowel: This is when a hole develops in the intestinal wall.
Learn about the risks of untreated UC.
Below are some commonly asked questions on pancolitis:
How serious is pancolitis?
Some people find managing pancolitis challenging, especially when they experience flare-ups and severe symptoms.
Pancolitis can cause serious complications if not managed well. Some complications can include perforation of the bowel, anemia due to blood loss, and cancer.
What is the best treatment for pancolitis?
There is currently no cure for UC, which includes pancolitis.
Treatment for pancolitis will depend on the severity of the condition and its symptoms. Medical management can include medications or surgery.
What is the life expectancy of a person with colitis?
A person with ulcerative colitis who manages their condition well can expect to have a similar life expectancy to someone without it.
However, experiencing complications
Pancolitis is a chronic condition with no cure, and people living with it can experience significant practical and emotional issues.
When some people experience a flare, they have to limit or change their activities. However, during periods of remission, most people can lead their lives as they typically do.
Pancolitis can affect relationships and work, but talking with and seeking emotional support from family, friends, and healthcare professionals can help.