Pancolitis


What is Pancolitis?

Pancolitis is known also as the “chronic inflammatory disorder of colon.” Medical Health Experts defined it as a condition where the colon is inflamed. It begins as ulcerative colitis and being proliferated all throughout the large intestine which includes the right and left colon, transverse colon and cecum down to rectum.

In most of the cases, the prevalence annual rate of Pancolitis is between 1 and 10 cases per 100,000 people depending on the specified region. According to the Journal American Family Physician, the occurrence of ulcerative colitis in United States affects between 250,000 and 500,000 people.

Moreover, Cleveland Clinic also supported the facts that the occurrence of Pancolitis mostly affected both gender (males and females) and worldwide speaking the disorder mostly concentrated in North America, Europe, Australia, North South Gradient Exists and higher latitudes region.

Unluckily, its precise causes are still unclear and undetermined by Medical Practitioner but most of them are ruling out that this kind of disorder is an autoimmune diseases and genetic predispositions.

Pancolitis (intestine)

Pathophysiology

Several studies have been published to tackle thoroughly the pathogenesis of ulcerative colitis or Pancolitis. In fact, the ulcerative colitis is linked to a dysregulated proinflammatory response to commensal gut bacteria.

According to Bret Lashner of Cleveland Clinic, this is because of the mutations, some of mucosal defense were being disrupted. Specifically, the MUC2 is the primary mucosal defense gene that coats the epithelium which also prevents the entry of foreign pathogens and microbes.

Furthermore, Genomewide Association have published a study relates that mutation in the MCU2 gene are linked with ulcerative Colitis.

Types of Ulcerative Colitis

There are four types of ulcerative colitis;

Ulcerative Proctitis

This type of colitis is a mild form of inflammation of rectum and accounts for 30% of all the ulcerative cases. In most of the reported cases, patients with this disorder experience a mild intermittent rectal bleeding and some can develop symptoms such as rectal pain, urgency in defecating, and tenesmus (painful urge caused by inflammation).

Ulcerative Proctitis

Proctosigmoiditis

The inflammation occurs in the rectum and sigmoid colon, it is the lower segment of the colon just right above the rectum. Similar symptoms are related with proctitis which includes rectal bleeding, urgency and tenesmus and some patients may experience and develop bloody diarrhea and cramps.

Left-sided colitis

This condition affects specifically the rectum that extends up the left colon including the sigmoid colon and descending colon.

Left-sided colitis

Pan-ulcerative Colitis

The inflammation affects the entire colon specifically the right and left colon, transverse and the rectum.

Pancolitis

Fulminant Colitis

This type of colitis is rare yet severe form of inflammation. People suffer from fulminant colitis are critically ill with the loss of fluid, experience abdominal pain, diarrhea accompanied by bleeding.

Patient suffers from this condition can develop megacolon (type of dilation of the colon due to intense inflammation and perforation (rupture of the colon).

Signs & Symptoms

Symptoms of the colitis are similarly generated the same signs and symptoms for all types of ulcerative colitis such as;

  • Bloody diarrhea
  • Abdominal Pain
  • Cramps
  • Weight loss
  • Fatigue
  • Fever
  • Night Sweats
  • Elevated Temperature
  • Loss of Appetite
  • Tenesmus ( urge for bowels)
  • Rectal Bleeding
  • Rectal Pain
  • Severe Diarrhea resulting to dehydration and even shock

Causes

Causes of general Pancolitis are still unclear and undetermined. However, some of the health experts associate the disease to Genetics, Immune system and environmental factors.

Genetics

Some of the health professionals linked the disease to genetics. In fact, recent research has identified the defective gene that associated with ulcerative colitis. Furthermore, according to MedicalNewsToday, about 1/5 of all patients with general ulcerative colitis including Pancolitis have close association who has/had the disease.

Environmental

Any bad external factor can contribute to develop to some ailments such as air pollution, smoking, and hygiene.

Intestinal Conditions

Any occurrence of disease affecting the homeostasis of small and large intestine can lead to Pancolitis. The intestine can be susceptible through infection and inflammation due to bacterial and viral infection, also some major causes affecting the intestinal conditions are birth defects, congenital disorders, intestinal obstruction, IBS (Irritable Bowel Syndrome), food poisoning, Gastroenteritis, Appendicitis and toxic ingestion

High Consumption of Linoleic Acid

This is a common dietary polyunsaturated fatty acid that can be found in red meat, cooking oils and margarine. According to the research reported in the journal gut that 1/3 of all ulcerative colitis cases are associated with the high intake of the linoleic acid.

Diagnosis

In ruling out the possibility of having Ulcerative Colitis your medical doctor will ask you further question such as your medical history, symptoms, signs of anemia and tenderness in the abdominal area. Then will follow by the following diagnostic testing;

Stool Test

Examining the stool can help to rule out the possibility if there is presence of parasites which can likely cause some infection in the digestive organ. In addition, appearances of white blood cells indicate an inflammation disease that can possibly turn into ulcerative colitis or other types of colitis.

Blood Test

Analyzing the blood of the patient can suggests possible anemia. Health experts used specifically the ESR Test (Arythrocyte Sedimentation Rate) and CRP Test (C reactive protein) to check inflammation.

X-ray

Used to check megacolon or perforation

Barium Enema

This test is the used of barium solution added in the enema. The barium coats the lining of the rectum and colon that appear in the Xray.

Sigmoidoscopy

This test is performed by using a flexible tube with a camera at the end and inserted through the anus into the rectum. By using the test it can see the images of the rectum and lower part of the colon to check if there is an occurrence of inflammation.

Colonoscopy

Colonoscopy testing is use to inspect the entire colon and rectum by using a long, flexible viewing tube with camera then inserted through the anus then into rectum.

CT Scan

Scanning the abdomen can also use to check if the patient is suffering with a Crohn’s disease.

Treatment

Managing the treatments includes the intake of medication and performs surgeries. Patient with mild symptoms of the ulcerative colitis can be treated with an out-patient basis.

Three medications for Pancolitis;

Aminosalicylates

Specifically sulfasalazine is widely used to prevent relapses. It is given through the rectum in treating mild to moderate Pancolitis.

Immunosuppressant

If the patient does not respond to steroids, doctors may prescribe immunosuppressant drugs. This type of treatment helps to lower the immune system of the patient which reduces the inflammation in the colon or rectum area.

Infliximab (Remicade)

 This specific drug may prescribed by the doctors with patient with moderate to severe symptoms of Pancolitis. According to the research is said to work speedily at bringing on remission thus helps to prevent the need for surgery.

Other types of treatment

  • Limiting the consumption of dairy products
  • Try to consume low-fat foods
  • Eating small meals
  • Drink plenty of Water
  • Take some multivitamins
  • Talk to your dietician for further
  • Avoid stress
  • Biofeedback (Stress-reduction technique)
  • Breathing Exercises

Surgery

If the patient does not respond to oral medications, performing surgeries will highly advise by the specialist;

Colectomy

Inflamed colon is being removed thus the small intestine will be rerouted from the colon so the discarded products can be pass out of the body.

Ileostomy

Type of surgery that requires an incision in the stomach- small intestine is being pulled out and connects to an external pouch. Then, the pouch serves to collect waste material from the intestine. This ileonal pouch is assembled by the surgeon internally, from the small intestine and then connected in the surrounding muscles of the anus. Then pouch is being emptied same as we do the bowel movement.

References

  1. http://www.medicinenet.com/ulcerative_colitis/page2.htm
  2. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gastroenterology/ulcerativecolitis/
  3. https://en.wikipedia.org/wiki/Pancolitis
  4. http://diseasespictures.com/pancolitis/
  5. http://www.medicinenet.com/script/main/art.asp?articlekey=7366
  6. http://www.delzicol.com/uc/types/
  7. https://www.ibdrelief.com/learn/whatisibd/whatisulcerativecolitis/panulcerativecolitis
  8. http://www.medicalnewstoday.com/articles/163772.php
  9. http://www.mayoclinic.org/diseasesconditions/ulcerativecolitis/basics/lifestylehomeremedies/con20043763

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