What Is Pancolitis?

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Pancolitis is inflammation of the entire colon, or large intestine. It is a form of ulcerative colitis (UC), which is part of a group of conditions known as inflammatory bowel disease (IBD). The exact cause of pancolitis is not well understood. However, it may be brought on by certain intestinal infections or other inflammatory conditions.

Pancolitis is also known as pan-ulcerative colitis, extensive colitis, total colitis, or universal colitis. It is a chronic disease, meaning it is often brought on slowly over a long period of time and has no cure. 

Person with abdominal pain and possibly fever

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UC affects sections of your colon, causing ulcers (sores) in the lining of the intestinal walls. In pancolitis, the inflammation and ulcers cover the entire length of the colon.

Other types of ulcerative colitis include:

  • Ulcerative proctitis: Inflammation of the rectum
  • Proctosigmoiditis: Inflammation of the rectum and sigmoid colon
  • Left-sided colitis (including limited or distal colitis): Inflammation of the left side of the colon (rectum, sigmoid colon, and descending colon)

Pancolitis Symptoms


Pancolitis can be a progressive disease. The signs and symptoms of pancolitis can vary from person to person, as well as depending on the stage of the disease, which can make treating it challenging. Nevertheless, common symptoms include:

Causes

The exact cause of ulcerative colitis is still unknown. However, researchers have identified some contributing factors that might provoke the development of UC, including:

  • An incorrect immune response: Your immune system wrongly triggers an inflammatory reaction against your digestive tract.
  • Microbiome: The gut microbiome includes the bacteria, viruses, and fungi that live in your digestive tract and assist in digestion. Changes in the balance of these organisms may play a role.
  • Environmental factors: Diet, air pollution, or cigarette smoke may play a role.
  • Genetics: You are more likely to get UC if you have a first-degree relative with IBD. Additionally, certain genetic features have been identified in people with UC and other forms of IBD.

While you can develop pancolitis at any age, it is most commonly diagnosed in people between the ages of 15 and 30 years old.

Diagnosis

Your doctor will ask about your symptoms, general health, and medical history to get an idea of your overall health. They may also want to do a physical exam, blood tests, or ask for a stool sample. This can help rule out other possible causes for your symptoms, such as bacterial or viral infections.

If your doctor suspects any form of IBD, they will also likely refer you for a colonoscopy to examine your colon for ulcers as well as any other abnormal tissue. This is a procedure in which a long, thin tube with a light and camera on the end is inserted into your colon via the rectum.

Your doctor may also take a biopsy during the colonoscopy. This is a tissue sample from your colon that will be tested for any infections or diseases.

Treatment

There are several different treatment options for pancolitis, depending on the severity of the ulcers in your colon and symptoms you are experiencing. Treatment may also vary if you have any underlying conditions that caused pancolitis or if untreated pancolitis has caused more severe conditions.

Lifestyle Changes

One of the first steps you can take to help relieve symptoms of pancolitis is to make some lifestyle changes. Many people with pancolitis will notice that certain foods or stressors can trigger flare-ups. 

The following lifestyle changes may help relieve your symptoms, especially during a flare-up:

  • Limit dairy products.
  • Avoid carbonated beverages.
  • Avoid caffeinated beverages like coffee and alcohol.
  • Reduce high-fiber foods.
  • Avoid spicy foods.
  • Drink plenty of water throughout the day.
  • Eat small meals.
  • Exercise.
  • Reduce stress.
  • Get seven to nine hours of quality sleep each night.

If you are unsure about what foods are triggering your pancolitis to worsen, you might find it helpful to keep a food diary to identify foods you should avoid during a flare-up.

If you are having difficulty pinpointing any triggers, your diet has become very limited, or you are losing weight without trying to, meet with a registered dietitian.

Medications

The most common medications for pancolitis and other forms of UC are anti-inflammatory drugs, such as oral 5-aminosalicylates (5-ASAs) and corticosteroids. These work to reduce the inflammation in your colon. 

Corticosteroids, such as prednisone, are another common medication for pancolitis. This potent medicine can be taken orally, or given as an injection, as a suppository, or through an enema. 

Corticosteroids are used only as a short-term treatment because there are many possible side effects, such as nausea, heartburn, weight gain, and increased risk of osteoporosis, diabetes, and high blood pressure.

Other common medications for pancolitis and UC are immune system suppressors or immunomodulators. These help reduce inflammation in your colon by decreasing the activity of your immune system. This can keep your immune system from attacking your colon and causing inflammation and ulcers.

Immunomodulators can have serious side effects, including increased risk of infections, anemia, and cancer. To be sure the medicine is working properly, you might need to meet with your doctor on a fairly regular basis.

Biologic therapies, such as Remicade (infliximab), are another option if you do not respond well to other treatments. These medications neutralize proteins made by the immune system to help decrease inflammation in your gastrointestinal (GI) tract.

The American Gastroenterological Association is pushing for the earlier use of biologic therapies for people with UC. Side effects of biologic therapies include a toxic reaction to the medication and an increased risk of developing infections, such as tuberculosis.

Surgery

If you are not responding to medications and your pancolitis is severely affecting your quality of life, you may be a candidate for surgery. The surgery usually performed for pancolitis is called a proctocolectomy, which involves removing your entire colon and rectum, so there are no chances of pancolitis or UC returning. 

During the surgery, your doctor will create a new passageway for stool to exit your body. Because of the major changes to your digestive tract, this surgery is usually reserved as a last resort for pancolitis treatment.

Prognosis

There is no cure for pancolitis or any other form of UC besides surgery to remove your colon. Pancolitis is a chronic condition, although symptoms can vary over time. You may have periods of no symptoms, or they may be mild, causing little to no interruption to your daily life. 

You might have periods of time with flare-ups that cause more severe symptoms and impact your quality of life greatly. Flare-ups with pancolitis may be more severe and debilitating than with other forms of UC because your entire colon is affected, compared with only certain sections of it with other forms.

If left untreated, pancolitis could cause serious conditions such as colorectal cancer, gastrointestinal perforation (a hole in your colon), or toxic megacolon.

Coping

Pancolitis can affect your quality of life, as well as your relationships and work. However, talking to and seeking support from family, friends, therapists, and other healthcare professionals can help. 

Other coping strategies include becoming educated on your disease, problem-solving, and positive reevaluation of upsetting or stressful experiences. In addition, you can improve your quality of life and reduce symptoms and complications by sticking to your treatment plan, limiting possible triggers, and visiting with your healthcare team on a regular basis.

Summary

Pancolitis is a form of ulcerative colitis in which there is chronic inflammation along with ulcers throughout your colon. It has symptoms including abdominal pain, bloody stools, and diarrhea. The exact cause is unknown. It is diagnosed by physical examination and colonoscopy.

Treatment for pancolitis includes lifestyle changes and medications to manage the symptoms. Surgery to remove the colon and rectum may be done in severe cases and is the only cure.

A Word From Verywell

Living with a chronic condition like pancolitis can be frustrating and very challenging at times. Nevertheless, it’s important to remember that the majority of people with UC are able to live full, happy lives.

By being a lifelong learner and working as a team with your family, friends, and healthcare professionals, you too can take charge of your pancolitis and enjoy a great quality of life.

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