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Pancolitis - Causes, Symptoms, Diagnosis, and Treatment

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Pancolitis is a form of ulcerative colitis that leads to inflammation of the entire colon. Read the article below to learn about it.

Written by

Dr. Gayathri. N

Medically reviewed by

Dr. Ghulam Fareed

Published At January 13, 2023
Reviewed AtJuly 10, 2023

What Is Pancolitis?

Pancolitis is a form of inflammatory bowel disease. It is otherwise known as pan ulcerative colitis. It is also called total or universal colitis. Ulcerative colitis is a chronic autoimmune disease that can affect the colon. The colon is the longest part of the large intestine connecting the small intestine on one side and the anus on the other. Small ulcers can develop on the colon in ulcerative colitis, producing pus and mucus. This also can lead to abdominal discomfort, diarrhea, and bleeding in the rectum. When this condition inflames the entire colon, then it is termed pancolitis. Some experts suggest that around 20 percent of people with ulcerative colitis will also present with pancolitis.

What Are the Symptoms of Pancolitis?

The common symptoms of pancolitis include

  • An exhausted kind of feeling.

  • Abnormal weight loss.

  • Pain and cramps in the stomach and the abdomen.

  • Feeling a strong, frequent urge for bowel movements. And sometimes, it becomes difficult to control.

As this condition worsens, the individual will more likely experience severe symptoms, which include the following:

  • Pain and bleeding from the rectal and anal area.

  • Unexplained fever.

  • Bloody diarrhea.

  • Diarrhea filled with pus.

Children having this condition may not grow properly. Some of the symptoms may not necessarily be due to pancolitis. Gas, bloating, or food poisoning can lead to cramping, pain, and a powerful urge to pass the waste. In these cases, the symptoms will disappear after a short period of discomfort.

If an individual has the following symptoms, it is advisable to visit a doctor at the earliest:

  • Blood or pus in the stool.

  • Fever.

  • Diarrhea lasts for more than two days without responding to medication.

  • Severe pain in the abdomen or rectum.

What Are the Causes of Pancolitis?

The cause of pancolitis is unclear. However, it can be caused due to genetic background. The Crohn's and colitis foundation of America states that there is ongoing research on how genetics can cause ulcerative colitis and other inflammatory bowel disorders.

  • This research includes how genes interact with the bacteria in the gastrointestinal tract. It is thought that the immune system can mistakenly target the colon while attacking the bacteria or viruses that cause the infection in the colon. This condition can cause inflammation and damage the colon leading to ulcers. It can also make it harder for the body to absorb certain nutrients.

  • The environment can play a major role. Some medications, such as non-steroidal anti-inflammatory drugs or antibiotics, may increase the risk. A high-fat diet may also be a factor. In some cases, if the patient does not get treatment for mild or moderate forms of ulcerative colitis, it can worsen and become a case of pancolitis.

  • Some believe that stress and anxiety can lead to ulcerative colitis and pancolitis. Stress and anxiety can trigger ulcers and cause pain and discomfort. Stress and anxiety ulcers can trigger ulcers causing pain and discomfort, but they do not cause pancolitis or other inflammatory bowel diseases.

How Is Pancolitis Diagnosed?

  • Physical Examination: The doctor may perform a physical examination to inspect the overall health.

  • Laboratory Tests: The doctors might ask for a stool sample or take blood tests to rule out other possible causes, such as bacterial or viral infections.

  • X-Ray: The doctor might also take an X-ray to rule out any serious complications within the abdomen if there are any signs or symptoms.

  • Colonoscopy: The doctor or a trained healthcare professional will insert a long flexible tube containing a camera with a light attached to it to examine the interior portions of the colon. The doctor will also examine the small intestine's lining to look for ulcers and other abnormal tissues. Colon polyps can also be found and removed easily using this procedure. These procedures will become necessary if the doctor suspects cancer in the colon.

  • Biopsy: During a colonoscopy, the doctor may take a tissue sample from the colon to test for any infections or diseases. This process of taking a tissue sample is called a biopsy.

What Are the Treatment Options for This Condition?

Treatment for pancolitis and other forms of ulcerative colitis will depend on how severe the inflammation in the colon is. The treatment options can also vary if there are other causes for pancolitis or if the untreated pancolitis has led to more severe forms of the disease.

1) Medications: Anti-inflammatory drugs are the most sought treatment for pancolitis and other forms of ulcerative colitis. These help in treating the inflammation in the colon. The following medications can be used for pancolitis treatment:

  • Aminosalicylates: This medication can help reduce inflammation. These are available as tablets or capsules for the rectum. A person can also receive those medications through an enema. Enema is a procedure in which liquid or gas is injected into the rectum to excrete its contents, introduce drugs, or permit X-ray imaging. Doctors prescribe these medications for mild or moderate cases, and they rarely cause side effects.

  • Corticosteroids: They are used to reduce inflammation. They are safely administered orally, directly, or through an enema. These can cause serious side effects such as osteoporosis (bones become weak and brittle) or cataracts (lenses become cloudy). Hence, doctors do not generally prescribe them as a long-term treatment.

  • Immunomodulators: These can reduce the overall activity of the immune system. These can be taken as tablets to treat mild or moderate symptoms. These can even weaken some people and make them vulnerable to infections and anemia (lack of red blood cells).

  • Biologics: These are medications developed from blood, viruses, and microorganisms to treat various conditions affecting health. They can be administered intravenously, which is through veins by injection.

2) Surgery: Surgery will be the treatment of choice if the flare-ups significantly impact a person’s quality of life or if the condition does not respond to medications. The surgery would usually involve the complete removal of the colon, which can completely prevent the recurrence of ulcerative colitis. However, anyone considering this surgery will have to consider the consequences too. After removing the colon, a special bag will be attached outside the body to collect wastes that will exit the small intestine via a hole in the abdomen. This procedure is called an ileostomy. The person can opt for a second surgery later in which an ileoanal pouch will be attached, connecting the small intestine and the anus through which the stools can pass normally.

What Are the Complications Associated With Pancolitis?

The complications associated with this condition are as follows:

  • Cancer: If pancolitis is present in an individual for a long period, there is a high chance of the person getting bowel cancer.

  • Toxic Megacolon: It is a condition in which the colon dilates without obstruction. The dilation can involve the entire colon, or it can also be partial. The symptoms include fever, abdominal pain, malnutrition, and colon rupture. It leads to systemic toxicity and is a medical emergency that must be addressed immediately.

  • Anemia: It is a condition with a lack of iron in the blood. It occurs due to loss of blood in severe cases of pancolitis.

  • Fulminant Colitis: It is a rare and severe form of pancolitis that will present with symptoms such as dehydration, severe pain in the abdomen, diarrhea with blood, and shock.

  • Perforation in the Bowel: In which a hole occurs in the intestinal walls.


Pancolitis is a long-standing condition with no cure. Individuals suffering from this condition should limit their activities when symptoms occur and can lead a normal life when the symptoms are treated. Individuals can have emotional and physical stress. But with the right support from friends, family, and the healthcare team, the patient can cope with this condition better.

Frequently Asked Questions


What Is the Definition of Pancolitis Ulcerative Colitis?

Ulcerative colitis is a persistent condition characterized by inflammation in the colon and rectum and this inflammatory bowel disease is thought to arise from an atypical immune system reaction.


Which Antibiotic Is Recommended as the Most Effective Treatment for Pancolitis?

Several antibiotics are commonly employed in the treatment of pancolitis, including:
 - Metronidazole 
 - Ciprofloxacin 


What Care Plan Options Would a Nurse Choose for a Patient Diagnosed with Pancolitis?

- A nurse caring for a patient with pancolitis may include the following interventions.
- Monitoring for signs of infection or complications.
- Administering medications as ordered
- Providing education on lifestyle modifications
- Self-care.


What Is the Most Effective Medication for Treating Pancolitis?

Various medications may be prescribed to address the symptoms and manage the condition, such as:
- Aminosalicylates.
- Corticosteroids.
- Immunomodulators.
- Biologics. 


How Does the Colon Function When Affected by Pancolitis?

Pancolitis can affect the colon in various ways, including causing the following:
- Inflammation.
- Ulcers.
- Bleeding. 
- Susceptibility to infection.


How Long Does It Typically Take for Pancolitis to Heal?

The time it takes for pancolitis to heal may depend on the following:
- The severity of the condition.
- Individual's response to treatment.
- Presence of any complications. 


What Type of Pain Is Associated with Pancolitis?

Common symptoms include the following.
- Abdominal Pain.
- Cramping.
- Rectal pain.


What Is the Duration of a Pancolitis Flare-Up?

The length of a pancolitis flare-up can differ depending on the individual and the intensity of their condition, and it can persist for a few days to multiple weeks, accompanied by symptoms like diarrhea, abdominal discomfort, and rectal bleeding.


Is It Possible for Ulcerative Pancolitis to Resolve on Its Own?

Ulcerative pancolitis is a chronic condition that may require ongoing management to achieve remission and prevent future flare-ups. Medications and lifestyle modifications may be used to manage symptoms and reduce inflammation in the colon.


How Long Does It Take to Achieve Full Recovery from Colitis?

The duration of the recovery process from colitis can vary, depending on how severe the condition is and how an individual responds to treatment; In contrast, some individuals may achieve remission within a few weeks, while others may need ongoing management to control their symptoms and maintain a stable condition effectively.


Can Individuals with Pancolitis Live a Normal Life?

Individuals with pancolitis can lead normal lives with the right treatment and management.


Which Foods Should Be Avoided by Individuals with Colitis?

Foods to be avoided by individuals with colitis are as under:
- Spicy foods.
- Alcohol
- Caffeine.
- High-fiber foods.
- Dairy products. 


What Options Are Available for Relieving Symptoms Associated with Pancolitis?

Available relief options for pancolitis include the following: medications as Aminosalicylates.
- Corticosteroids
- Immunomodulators.
- Biologics.
- Stress reduction.
- Dietary modifications 
- Regular exercise 


What Are the Treatment Options for Polyglandular Autoimmune Syndrome Type 2?

Treatment for polyglandular autoimmune syndrome type 2 may include the following.
- Replacement therapy. 
- Immunosuppressive medications.


How Do Autoimmune Diseases Impact Pregnancy?

Autoimmune diseases can increase the risk of complications during pregnancy, including the following:
- Preterm labor.
- Preeclampsia.
- Miscarriage. 
Source Article IclonSourcesSource Article Arrow
Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology


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