From the Guidelines
Pancolitis is a severe form of ulcerative colitis that affects the entire colon, from the cecum to the rectum, characterized by diffuse mucosal inflammation limited to the colon. According to the most recent and highest quality study, 1, ulcerative colitis is a chronic inflammatory condition that causes continuous mucosal inflammation of the colon, usually without granulomas on biopsy. Pancolitis is a type of extensive colitis that affects the whole colon, as defined in the guidelines for the management of inflammatory bowel disease in adults 1.
The symptoms of pancolitis include bloody diarrhea, abdominal pain, urgency to defecate, weight loss, and fatigue. Treatment typically involves anti-inflammatory medications, such as 5-aminosalicylates, corticosteroids, and immunomodulators, as well as biologic therapies like infliximab or adalimumab for moderate to severe disease 1. Patients with pancolitis should stay hydrated, follow a low-residue diet during flares, and have regular follow-up appointments with gastroenterologists.
Some key points to consider in the management of pancolitis include:
- The extensive inflammation in pancolitis results from an abnormal immune response in genetically susceptible individuals, causing the immune system to attack the colon's lining 1.
- Pancolitis carries a higher risk of complications, including toxic megacolon, perforation, and colorectal cancer, so regular colonoscopy surveillance is recommended beginning 8-10 years after diagnosis 1.
- The European consensus on the histopathology of inflammatory bowel disease provides guidelines for the histologic diagnosis of chronic colitides, including pancolitis 1.
Overall, the management of pancolitis should prioritize reducing inflammation, preventing complications, and improving quality of life, with a focus on individualized treatment and regular follow-up care 1.
From the Research
Definition of Pancolitis
Pancolitis refers to a condition where there is inflammation of the entire colon, which is a characteristic feature of ulcerative colitis (UC) 2, 3, 4.
Characteristics of Pancolitis
- Pancolitis is a type of ulcerative colitis that affects the entire colon, from the rectum to the cecum 2, 3.
- It is characterized by contiguous inflammation of the colonic mucosa, which can lead to symptoms such as bloody diarrhea, urgency, and tenesmus 5.
- Pancolitis can be a severe form of UC, with a higher risk of complications such as colorectal cancer and need for surgery 3.
Prevalence of Pancolitis
- Approximately 92.7% of patients with severe ulcerative colitis have pancolitis 3.
- Pancolitis is more common in patients with severe UC, and is often associated with a higher risk of surgery 3.