What Is UC Pancolitis?

• Having more than six bowel movements a day
• Seeing blood in stool with most bowel movements
• Nausea or vomiting

• Mucus or pus in stool
• Abdominal cramps and pain
• Tenesmus (constant urge to have a bowel movement)
• Sudden, urgent need to have a bowel movement
• Weight loss
• Fatigue
• Fever

• Genetics
• Abnormal immune system function
• Differences in gut bacteria (the gut microbiome)
• Environmental factors

• Colonoscopy Typically done under conscious sedation anesthesia, this procedure involves inserting a camera mounted on a thin, flexible tube into the rectum. This allows your provider to see any inflammation in the colon and take tissue samples for biopsy.
• Flexible sigmoidoscopy Similar to a colonoscopy, this procedure uses a camera on a thin tube, but in this procedure, the provider only looks at the rectum and lower end of the colon (the sigmoid colon). This test is most often used if there is severe inflammation in the colon.
• Blood tests Blood tests can check for anemia (a lack of red blood cells which carry oxygen throughout your body), infection, and inflammation.
• Stool tests Stool samples containing white blood cells or specific proteins can indicate UC, and these tests can also rule out infections that can also cause pancolitis and other conditions.
• Imaging To identify possible complications and levels of inflammation, you may need imaging tests such as an X-ray, computed tomography (CT) scan, CT enterography, or magnetic resonance enterography.

Medication Options

• Anti-Inflammatory agents These medications are typically tried first if the disease is mild.

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  They include oral 5-aminosalicylates like sulfasalazine (Azulfidine) and mesalamine (Delzicol, Lialda) and corticosteroids like prednisone (Deltasone) and budesonide (Entocort EC).
• Immunomodulators These medications lower inflammation by suppressing your body's immune response. They include azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan), and cyclosporine (Gengraf, Neoral, Sandimmune).
• Biologics The biologic medication class targets proteins in the immune system to help manage UC symptoms. Biologics include tumor necrosis factor (TNF) inhibitors like infliximab (Remicade), adalimumab (Humira) and golimumab (Simponi), plus other biologics like vedolizumab (Entyvio), ustekinumab (Stelara), mirikizumab (Omvoh), and risankizumab (Skyrizi). They may be used for moderate to severe UC.
• Small molecules These oral medications reduce inflammation caused by the immune system. They include Janus kinase (JAK) inhibitors like tofacitinib (Xeljanz), upadacitinib (Rinvoq), and filgotinib (Jyseleca), as well as sphingosine-1-phosphate (S1P) receptor modulators like ozanimod (Zeposia). The U.S. Food and Drug Administration (FDA) has issued a warning about a possible increased risk of serious heart issues and cancer after taking tofacitinib. If you take tofacitinib, ask your healthcare provider before making any changes to your treatment plan.
• Antidiarrheals You may need to take antidiarrheal medications, like loperamide (Imodium A-D), in some cases. You should only take them for severe diarrhea with a healthcare provider's approval to avoid the risk of toxic megacolon (severe inflammation resulting in an enlarged colon), a life-threatening potential complication of UC.
• Pain relievers For pain, your provider may recommend acetaminophen (Tylenol), but be sure to avoid NSAIDs like ibuprofen (Advil, Motrin IB), and naproxen sodium (Aleve), which can irritate the intestines.
• Supplements Your provider may recommend iron supplements to prevent anemia if you have ongoing bleeding, and vitamin D and calcium to help prevent bone loss. Talk to your provider before trying any new over-the-counter supplements or medications.

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Surgery

Complementary and Integrative Therapies

Certain lifestyle changes can help you avoid symptom flare-ups.

Make Changes to Your Diet

• Keep dairy at a minimum. Lactose intolerance (inability to digest milk products properly) is more common in people with IBD. Avoiding dairy may lessen flare-like symptoms. You can also ask your provider about lactose-free milk and dairy products, which may be more easily digestible for you.
• Eat frequent small meals. Your intestines may be able to handle five or six small meals a day better than fewer, larger meals.
• Stay hydrated. Drink plenty of water each day (current guidelines recommend 11.5 cups for women and 15.5 cups for men), and try to limit or avoid dehydrating beverages like alcohol and caffeine, which may trigger symptoms in some people.

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Avoid NSAIDS

Manage Stress

• Try relaxation and meditation.
• Get at least seven hours of sleep every night.
• Exercise every day.

• Severe rectal bleeding
• Perforated colon (a break or hole in the colon)
• Severe dehydration
• Anemia (low red blood cell count)
• Osteoporosis (bone loss)
• Skin, joint, and eye inflammation
• Toxic megacolon
• Inability to hold in a bowel movement
• Sexual dysfunction
• Pelvic abscess
• Blood clots

• Crohn's disease A form of IBD that's similar to UC, but it can affect any part of the GI tract rather than only the colon
• Parasitic colitis A form of UC that's caused by organisms like Entamoeba histolytica
• Tuberculosis A bacterial infection that most often affects the lungs,

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   but can also affect the GI tract

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• Radiation colitis A form of UC that results from radiotherapy for gynecological, urological, and rectal cancers
• Colorectal cancer A type of cancer affecting the colon and rectum

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• Toxic megacolon A rare, life-threatening form of colon disease involving severe inflammation and enlargement of the colon

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• Bacterial/viral gastroenteritis An infection caused by bacteria like E. coli, salmonella, and C. difficile, or viruses like cytomegalovirus

Crohn's & Colitis Foundation

The Crohn's & Colitis Foundation provides a range of virtual and in-person support groups for people with an IBD like UC pancolitis. In these groups, anyone with an IBD and their caregivers can connect, share experiences, and get emotional support. They also offer educational resources, patient programs, and advocacy tools to help people live well with IBD.

Connecting to Cure Crohn's & Colitis

Connecting to Cure Crohn's & Colitis raises funds for IBD research and offers education, support groups, and community events for those with IBD. Their mission is to support patients and families, raise awareness, and help accelerate the search for better treatments and a cure for Crohn's disease and UC.

Girls With Guts

Girls With Guts empowers women and nonbinary individuals with IBD or ostomies through virtual groups, retreats, and other resources. They aim to foster connections, help people build confidence, and promote self-advocacy, creating supportive spaces to share experiences and challenge stigma.

• Pancolitis is a severe form of ulcerative colitis (UC) involving the entire colon.
• Often referred to as UC pancolitis, symptoms may include blood and mucus in bowel movements, weight loss, abdominal cramps and pain, nausea and vomiting, and fever, among others.
• UC pancolitis is treated with medications like biologics, immunomodulators, small molecule drugs, and others. If medications don't work well enough for you, surgery may be needed.