Approximately 14%–35% of patients with ulcerative colitis will develop pancolitis.
Causes
The cause of ulcerative colitis is not well understood by researchers, but it is thought to be the result of complex interactions between the intestinal lining and immune system. The immune system mistakenly attacks the cells of the intestine, causing inflammation, ulcers, and sores. Other factors that may influence the development of ulcerative colitis include genetics, age, gut microbiota, toxic pathogens, and the environment.
People who develop pancolitis start with some form of ulcerative colitis, which begins in the rectum. Over time, the inflammation extends to more of the surrounding tissue. When the entire colon is affected by the inflammation, the condition is called pancolitis.
Symptoms
Patients with pancolitis have gastrointestinal symptoms that range from mild to severe. Symptoms may include:
More severe and active disease Chronic use of steroids Chronic use of immunosuppressants Certain bacterial or viral infections
Approximately one-third of ulcerative colitis cases will progress into pancolitis within 10 years.
Feeling tired or nauseated Unexplained weight loss Abdominal discomfort or pain Diarrhea without blood to frequent diarrhea with blood, pus, or mucus Urgency or immediate need to go to the bathroom High fever and tenderness in the stomach area
Diagnosis
A doctor will perform a variety of exams to determine a ulcerative colitis diagnosis. These can include a colonoscopy (a type of endoscopy that examines the large intestine and rectum), imaging tests, blood tests, and stool tests.
Symptoms may include:
Skin rash (tenderness, red bumps, dry, itchy, and flaky skin, scaly patches, welts, bruising, and painful sores)Painful, swollen jointsHeadacheSensitivity to lightBlurred visionBurningIncreased eye secretions
Once diagnosed, an endoscopy (a procedure in which a flexible tube with a light and camera is inserted into the body to observe the digestive tract) will be performed to determine the extent and severity of the ulcerative colitis.
When ulcerative colitis is diagnosed, the extent of the disease is determined by the Montreal classification system. The Montreal classification system has three subgroups that determine the extent (E) of the spread.
Medical therapy for pancolitis involves medication and surgery.
Medications
There are a variety of options for managing symptoms of pancolitis. Medications can include one or a combination of the following:
Aminosalicylates: Help control inflammation, especially with mild-to-moderate symptomsCorticosteroids: Help lessen inflammation, especially with moderate-to-severe symptoms but are short-term treatmentsImmunomodulators: Block the immune system response that causes inflammation and can help decrease swelling in the gastrointestinal tractBiological agents: Help lessen inflammation in severe cases that do not respond to other medications
Surgery
Sometimes, medicine is not enough to manage the symptoms of pancolitis, so surgery may be recommended. Approximately 40% of patients diagnosed with pancolitis will require surgery to treat the disease.
Surgeries that your doctor may discuss with you include:
Proctocolectomy (removes colon and rectum)Restorative proctocolectomy (removes the colon and rectum but allows the patient to continue to pass stool through the anus)
It’s important to speak with your healthcare team before making the decision to have surgery because surgery has serious implications and risks.
Prognosis
There’s no cure for pancolitis, but medications can help manage and alleviate symptoms. How patients respond to treatment depends on the severity of the disease, past complications, and response to previous treatments.
While pancolitis is generally not considered to be fatal, it can cause serious health complications if it is not managed. Some of the health conditions associated with unmanaged pancolitis include:
Increased risk of colorectal cancer: The risk of developing cancer increases every year with a diagnosis of pancolitis. Toxic megacolon: This condition is characterized by the inflammation of the deep tissue layers of the large intestine, causing it to swell and stop working. Dehydration and malabsorption: These conditions are caused by diarrhea and inflammation. Anemia: Anemia is a lack of healthy red blood cells that is caused by ulcers and bleeding.
A Word From Verywell
If you are experiencing persistent changes in bowel movements or any signs and symptoms of ulcerative colitis such as consistent abdominal pain, bloody stools, ongoing diarrhea, and urgency to use the bathroom, speak with your doctor.
It’s important to remember that everyone experiences symptoms of pancolitis differently, and there are a variety of treatment options to consider. Continue to communicate with your healthcare team to find the best combination of treatments to keep your symptoms as manageable as possible.
There was an error. Please try again.
