Pancolitis

Overview of pancolitis, a form of ulcerative colitis affecting the entire colon

Pancolitis

Diagram of the large intestine, which is affected in pancolitis

Pancolitis is a form of ulcerative colitis that involves inflammation of the entire colon. It is a chronic condition that can lead to significant complications if not managed properly. Pancolitis is characterized by diffuse inflammation and ulceration of the colonic mucosa, which can result in symptoms such as abdominal pain, diarrhea, and rectal bleeding.

Pathophysiology

Pancolitis is part of the spectrum of inflammatory bowel disease (IBD), which also includes Crohn's disease. The exact cause of pancolitis is not fully understood, but it is believed to involve a combination of genetic, environmental, and immune factors. The inflammation in pancolitis is continuous, starting from the rectum and extending proximally to involve the entire colon.

Symptoms

The symptoms of pancolitis can vary in severity and may include:

• Chronic diarrhea, often with blood and mucus
• Abdominal pain and cramping
• Urgency to defecate
• Fatigue
• Weight loss
• Fever

Diagnosis

The diagnosis of pancolitis is typically made through a combination of clinical evaluation, laboratory tests, and imaging studies. A colonoscopy with biopsy is the gold standard for diagnosis, allowing direct visualization of the colonic mucosa and histological examination of tissue samples.

Treatment

Treatment for pancolitis aims to reduce inflammation, manage symptoms, and maintain remission. Common treatment options include:

• Aminosalicylates (e.g., mesalamine)
• Corticosteroids for acute flares
• Immunomodulators (e.g., azathioprine)
• Biologic therapy (e.g., anti-TNF agents)
• Surgery may be necessary in severe cases or when complications arise

Complications

Pancolitis can lead to several complications if not adequately controlled, including:

• Increased risk of colorectal cancer
• Toxic megacolon
• Perforation of the colon
• Severe bleeding

Prognosis

The prognosis for individuals with pancolitis varies. With appropriate treatment, many patients can achieve and maintain remission. However, the risk of complications and the need for ongoing medical management remain significant.

Related pages

• Ulcerative colitis
• Inflammatory bowel disease
• Crohn's disease
• Colorectal cancer