Pancolitis is a form of ulcerative colitis that affects the entire large intestine or bowel. It is a type of inflammatory bowel disease.

Share on Pinterest
Pancolitis is inflammation of the entire colon.
Illustration by Yaja’ Mulcare

The full name of pancolitis is pan-ulcerative colitis. It is also sometimes called total colitis or universal colitis.

It is a chronic condition, meaning it develops over a long period, and there is currently no known cure.

Here are some 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.

Ulcerative colitis 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 ulcerative colitis, small ulcers can develop on the colon, producing pus and mucus. In turn, this can lead to abdominal discomfort, diarrhea, and rectal bleeding.

When the inflammation covers the entire colon, doctors will diagnose a person with pancolitis.

Experts estimate that around 20% of people who have ulcerative colitis will have pancolitis.

Other types of ulcerative colitis include:

The main symptoms of both ulcerative colitis in general and pancolitis are:

  • 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 (extreme tiredness)
  • weight loss
  • loss of appetite
  • fever
  • night sweats

Flare-ups

If a person has not experienced symptoms of pancolitis for a significant period, then the symptoms suddenly return, this is a flare-up or relapse.

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

Pancolitis is a subtype of ulcerative colitis, which is an inflammatory bowel disease. It is an autoimmune condition, which means that instead of defending the body against infection, the immune system attacks healthy tissue.

The exact cause of ulcerative colitis is not known, but scientists think that a combination of factors may lead to the development of the disease.

The different factors include:

  • a genetic predisposition, meaning something the person is born with
  • an abnormal reaction from the digestive system to bacteria in the intestine
  • unknown triggers, such as viruses, bacteria, stress, or diet
  • an abnormal immune response

While people of any age can develop pancolitis, doctors more commonly diagnose it in those between 15–25 years old.

Gender does not affect how likely a person is to develop the condition.

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 inflammatory bowel disease, they may refer the individual for further tests, including:

  • Blood tests: These can help when looking for cell counts and inflammatory markers.
  • X-ray or CT scan: These can help rule out serious complications within the abdomen if there are other concerning signs or symptoms.
  • 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 how severe the condition is and how much the symptoms affect the person’s life.

While there is no known cure, the two main aims of treatment are to reduce symptoms until they are gone, known as remission, and then to maintain remission.

The two types of treatment currently available are medication and surgery.

Medication

The four main forms of medications doctors may prescribe are:

  • Aminosalicylates can help reduce inflammation. These come as tablets or 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 are also used to reduce inflammation. These are safe to administer orally, as a suppository, or through an enema. 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 infusion or injection.

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 there is no chance of any form of ulcerative colitis returning.

However, anyone thinking about having this surgery must consider the consequences.

Once the colon has been removed, waste must instead 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 typical way.

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

Learn more about natural remedies for managing ulcerative colitis. A person should talk with a doctor before attempting any of these treatments.

There can be some very serious complications associated with pancolitis:

  • Cancer. The longer a person has had pancolitis, the greater their risk of developing bowel cancer.
  • Toxic megacolon is when the inflammation is very severe, and the colon dilates in size. Symptoms include fever, abdominal pain, dehydration, malnutrition, and colonic rupture. This is a medical emergency.
  • Anemia describes a lack of iron in the blood. It happens because of blood loss from the condition.
  • Fulminant colitis is a rare and severe form of pancolitis. Symptoms include dehydration, severe abdominal pain, diarrhea with blood, and shock.
  • Perforation of the bowel, which is when a hole develops in the intestinal wall.

Pancolitis is a chronic condition with no cure, and people living with it can experience significant practical and emotional issues.

When a person is experiencing a flare-up, they may have to limit or change their activities. However, during periods of remission, most people can lead a typical life.

Pancolitis can affect relationships and work, but talking with and seeking emotional support from family, friends, and healthcare professionals can help.

Read this article in Spanish.