Medical News Today: What you need to know about pancolitis

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

Its full name is pan-ulcerative colitis and is also sometimes known as total colitis or universal colitis.

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

Overview of ulcerative colitis

Image of the colon - pancolitis
Pancolitis affects the large intestine or bowel.

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.

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

Other types of ulcerative colitis include:

  • proctitis
  • proctosigmoiditis
  • left-sided colitis


The main symptoms of 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 of pancolitis can include:

  • tenesmus — the need to pass stools even when there is nothing in the bowel
  • fatigue, or extreme tiredness
  • weight loss
  • loss of appetite
  • fever
  • night sweats


If a person has not experienced symptoms of pancolitis for a significant period and then they suddenly return, it is known as 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

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Stress may lead to pancolitis
Unknown triggers such as diet, bacteria, and stress may lead to the development of ulcerative colitis.

Ulcerative colitis is a type of inflammatory bowel disease. It is an autoimmune condition, which means that instead of defending the body against infection, the immune system goes wrong and instead attacks healthy tissue.

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

The different factors include:

  • a genetic predisposition, which 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
  • abnormal immune response

While people of any age can develop pancolitis, it is more commonly diagnosed in those aged between 15 and 25 years old.

Both men and women are equally affected.

Diagnosis and when to see a doctor

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 and take 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, then they may refer the individual for further tests, including:

  • Blood tests to look at cell counts and inflammatory markers.
  • X-ray or computerized tomography (CT) scan to rule out serious complications within the abdomen if there are other concerning signs or symptoms.
  • Colonoscopy — 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 to be emptied before a colonoscopy. The procedure takes around 30 minutes and can be uncomfortable.

What are the treatment options?

Treatment for pancolitis will depend on how severe the condition is and how badly the symptoms are affecting 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 for pancolitis are medication and surgery.


The four main forms of medication given to treat pancolitis are:

  • Aminosalicylates (ASAs) to reduce inflammation. The medicine is available as a tablet or capsule, as a suppository in the rectum, or through an enema. It is prescribed for mild or moderate cases and rarely has side effects.
  • Corticosteroids also used to reduce inflammation. This powerful medicine can be administered orally, as a suppository, or through an enema. Not used as long-term treatment, as corticosteroids can cause serious side effects, such as osteoporosis and cataracts.
  • Immunomodulators to reduce the activity of the immune system. They can be taken as a tablet to treat mild or 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 intravenous (IV) infusion or injection.


surgeons working on a patient
A treatment option for pancolitis may be surgery, which should be carefully considered.

If flare-ups are having a serious impact on a person’s quality of life, or the person is not responding to medications, then surgery is an option.

Surgery usually involves removal of the colon entirely, which means there is no chance of any form of ulcerative colitis returning.

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

Once the colon has been removed, waste will instead leave the body from the small intestine via a hole in the abdomen. The waste passes into a special bag, known as an ileostomy.

A second surgery may then be performed 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 normally,

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There can be some very serious complications associated with pancolitis:

  • Cancer: The longer a person has had pancolitis, the greater the risk of developing bowel cancer.
  • Toxic megacolon: When inflammation is very severe, and the colon dilates in size. Symptoms include; fever, abdominal pain, dehydration, malnutrition, and colonic rupture. This is a surgical emergency.
  • Anemia: Lack of iron in the blood, caused by blood loss from the condition.
  • Fulminant colitis: A rare and severe form of pancolitis. Symptoms include; dehydration, severe abdominal pain, diarrhea with blood, and shock.


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

When someone is having a flare-up, they may have to limit or change their activities. However, during periods of remission most people can lead a normal and healthy life.

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

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