Pancolitis is a type of ulcerative colitis. It causes swelling and sores (ulcers) in the large intestine, also called the colon.

In ulcerative colitis, the immune system attacks healthy tissue instead of protecting the body from infection. This damages the inside lining of the colon.

In many people with ulcerative colitis, swelling starts in the rectum (the last part of the colon) and spreads upward. Pancolitis is different because it affects the whole colon. Because more of the colon is involved, pancolitis may be more severe and cause more symptoms than other types of ulcerative colitis.

Pancolitis happens when the immune system attacks the lining of the intestine. The exact cause is not known. Experts think it comes from a mix of factors.

These may include:

• Genetics (traits a person is born with).
• Environmental factors such as infections, stress, or diet.
• An unusual reaction to normal bacteria in the gut.
• Changes in gut bacteria, also called the microbiome.
• An abnormal immune response.
• Certain medicines.

People with inflammatory bowel disease (IBD) or certain gut infections may be at higher risk for pancolitis.

Pancolitis can cause symptoms in the digestive system and other parts of the body. Symptoms can range from mild to severe. They may come and go over time.

Common symptoms include:

• Diarrhea, often with blood or mucus.
• Frequent bowel movements.
• A feeling of needing to have a bowel movement, even when nothing comes out (called tenesmus).
• Belly pain and cramping.

Symptoms outside the digestive system include:

• Painful, swollen joints.
• Irritated eyes.
• Fatigue (feeling very tired).
• Loss of appetite.
• Weight loss.
• Sores in the mouth.
• Fever, in more severe cases.
• Night sweats.

Pancolitis often has periods when symptoms get worse (flares) and then periods when they improve (remission). Flares may be triggered by infections (such as C. difficile), missed doses of medicine, or changes in the disease. Some pain relievers, such as ibuprofen, may also make symptoms worse.

Over time, pancolitis can increase the risk of colon cancer, especially after many years.

Your doctor will review your symptoms, run tests, and check your colon.

A key test is a colonoscopy. During this test, a doctor uses a thin flexible tube with a light and camera attached to the end to look inside the colon. The doctor may also take a small tissue sample, called a biopsy. If swelling is seen in the whole colon, it may be pancolitis.

Other parts of diagnosis may include:

• A review of medical history.
• A physical exam.
• Imaging tests.
• Stool tests to check for infections.
• Blood tests to look for signs of inflammation.

There is no cure for pancolitis, but treatment can help control the disease. Treatment depends on how severe it is and how much it affects your daily life.

The goals of treatment are to reduce swelling, heal the lining of the colon, control symptoms, and help you reach and stay in remission without steroids. Other goals are to prevent hospital stays, surgery, and long-term problems.

Treatment often includes medicines that reduce swelling or calm the immune system.

In more severe cases, or when medicines do not work, surgery may be needed to remove all or part of the colon. This surgery is called a colectomy.

Pancolitis is a long-term (chronic) condition that needs ongoing care. Lifestyle changes do not cure the disease, but they can help reduce flares and improve your quality of life.

Helpful steps include:

• Eating healthy foods and avoiding trigger foods.
• Managing stress.
• Taking medicines as prescribed.
• Going to regular follow-up visits and getting recommended tests.

People with long-term pancolitis should have regular colon cancer screening. Screening often starts about 8 years after diagnosis.

People who take medicines that weaken the immune system should stay up-to-date on vaccines and help prevent infection.

The right treatment can help you stay in remission and prevent problems.