Ulcerative colitis is a nonspecific inflammation of the large intestine with a relatively unknown cause. It may involve the rectum alone (ulcerative proctitis) or the sigmoid and rectum (proctosigmoiditis). It could also affect the entire colon, referred to as pancolitis. Pancolitis is one of the most severe types of ulcerative colitis.
As mentioned earlier, the cause of pancolitis is not yet well known. Stress was once pointed out as the main trigger of the disease, but scientific studies have found out that it is not. However, stress is known to aggravate the disease once it is already present.

There are, however, possible explanations as to why pancolitis occurs. One theory suggests that the inflammation is triggered by the presence of a particular virus or bacterium—the inflammation might be due to the immune system response. It is also suggested that the inflammation might be caused by an autoimmune reaction.
Some studies are looking into the possibility of a certain gene passing on the disease. It has been observed that parents who have pancolitis are more likely to have children who carry the disease. This idea is still being studied as there are a number of individuals who suffer from the disease without any known family history.
The characteristic sign of the disease is the formation of lesions in the crypts of Lieberkuhn. The inflammatory process leads to the formation of tiny mucosal hemorrhages, which in time worsen, and develop, into abscesses. The lesions caused by inflammation may become necrotic and form ulcers.
Diarrhea is the most common manifestation of pancolitis. And the severity varies according to the stage of the disease. Bowel movements may reach up to 30 to 40 times a day. Because the disease affects the mucosal layer of the bowel, it is common to observe blood in the stool. Night time diarrhea often happens when daytime symptoms are severe.
Other symptoms aside from diarrhea can also be present. Anorexia or the lack of appetite is another common symptom. The patient will also experience body weakness and fatigue. Abdominal cramping may also occur. Fecal incontinence, the loss of the ability to control one’s bowel, is another manifestation.
Diagnosis of pancolitis is based on history and physical examination. The diagnosis is usually confirmed by a proctosigmoidoscopy—a test which uses a telescope-like device to view the inside of the bowels.

Pancolitis

Pancolitis

Treatment of Pancolitis depends on the extent of the disease and the severity of the symptoms. Treatment for this kind of ulcerative colitis usually involves measures to control the acute signs and symptoms of the disease. Preventive measures are also taken. Some people with mild to moderate manifestations are able to manage the disease by simply avoiding certain foods. Caffeine-containing beverages, lactose, dairy products, spicy foods, and gas-forming foods should be avoided. Fiber supplements are sometimes used to decrease diarrhea and other rectal symptoms.
Medications such as TNF-inhibitors, corticosteroids, 5-aminosalcylic acid derivative, and Balsalazide may also be given. Antibiotics are also given to avoid sepsis often associated with severe colitis.
Most of the cases of pancolitis are not fatal. However, there are instances when the disease is severe enough to cause death. That is why it is always better to seek medical attention when the presence of the disease is suspected.

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