From the Guidelines
Pancolitis is primarily caused by inflammatory bowel diseases, with ulcerative colitis being the most common cause, as evidenced by the most recent study in 2021 1.
Causes of Pancolitis
The causes of pancolitis can be broken down into several categories, including:
- Inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease, which are the most common causes of pancolitis, with ulcerative colitis affecting the entire colon and Crohn's disease affecting the entire colon, as well as other parts of the digestive tract 1.
- Infectious causes, including severe bacterial infections like Clostridium difficile, Salmonella, Shigella, and certain parasitic infections, which can trigger widespread colonic inflammation 1.
- Ischemic colitis, resulting from reduced blood flow to the colon, which may occasionally present as pancolitis in severe cases 1.
- Radiation therapy to the abdomen or pelvis, which can induce radiation colitis affecting the entire colon 1.
- Certain medications, particularly non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, and immunosuppressants, which may trigger drug-induced pancolitis in susceptible individuals 1.
Risk Factors
Genetic factors play a significant role in inflammatory bowel disease-related pancolitis, with family history increasing risk, as noted in a study from 2017 1. Environmental factors, such as smoking, diet high in processed foods, stress, and antibiotic use, may contribute to disease development or exacerbation in genetically predisposed individuals, as reported in a study from 2004 1.
Clinical Features
The clinical features of pancolitis include symptoms such as bloody diarrhea, abdominal pain, urgency, and weight loss, as well as extra-intestinal manifestations, such as arthritis, skin disorders, and uveitis, as described in a study from 2021 1.
Management
The management of pancolitis aims to achieve induction of remission, followed by maintenance therapy to prevent recurrent disease flares, with treatment options including immunosuppressive therapies, biologics, and surgery, as outlined in a study from 2021 1.
From the Research
Causes of Pancolitis
Pancolitis refers to inflammation of the entire colon. The causes of pancolitis can be understood by looking at the various forms of inflammatory bowel disease (IBD) that can lead to this condition.
- Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disorder that can cause continuous mucosal inflammation extending from the rectum to the more proximal colon, with variable extents 2.
- The key risk factors for UC include genetics, environmental factors, autoimmunity, and gut microbiota 2.
- Microscopic colitis (MC) is another form of IBD that can cause inflammation of the colon, although it is typically characterized by a more subtle inflammation that can only be seen under a microscope 3, 4.
- The causative factors for MC include smoking, alcohol consumption, medications, genetic factors, autoimmune diseases, bile acid malabsorption, obesity, appendicitis, and intestinal dysbiosis 3.
Risk Factors for Pancolitis
The risk factors for pancolitis are similar to those for UC and MC, and include:
- Genetics: UC has a genetic component, with certain genetic mutations increasing the risk of developing the disease 2.
- Environmental factors: Environmental factors, such as diet and stress, can also play a role in the development of UC and MC 2, 3.
- Autoimmunity: Autoimmune disorders, such as rheumatoid arthritis and lupus, can increase the risk of developing UC and MC 2, 3.
- Gut microbiota: An imbalance of the gut microbiota, also known as dysbiosis, can contribute to the development of UC and MC 2, 3.
Disease Extent and Severity
The extent and severity of pancolitis can vary depending on the underlying cause.
- UC can cause continuous mucosal inflammation extending from the rectum to the more proximal colon, with variable extents 2.
- MC can cause inflammation of the entire colon, although the inflammation is typically more subtle than in UC 3, 4.
- The severity of pancolitis can be assessed using various scoring systems, such as the Mayo scoring system for UC 2.