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Dolichocolon May Differentially Associate with Ulcerative Colitis Phenotype in Children.

Richard Kellermayer1,2,3, Donovan P Berens4, Réka G Szigeti5

  • 1Division of Pediatric Gastroenterology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA. kellerma@bcm.edu.

Digestive Diseases and Sciences
|May 25, 2026
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Summary

Dolichocolon (DC), an anatomical variant, may be linked to ulcerative colitis (UC) phenotypes, potentially influencing disease distribution irrespective of constipation. Further research is needed to confirm these findings.

Keywords:
ChildrenConstipationInflammatory bowel diseasePhenotype modifierRedundant colon

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Area of Science:

  • Gastroenterology
  • Pediatric Gastroenterology
  • Radiology

Background:

  • Dolichocolon (DC) is an underrecognized anatomical variant.
  • The association between dolichocolon and ulcerative colitis (UC) remains unknown.

Purpose of the Study:

  • To investigate the association between dolichocolon and ulcerative colitis (UC) in children.
  • To explore potential links between DC subtypes and UC phenotypes.

Main Methods:

  • Retrospective review of abdominal MRI and CT scans in children.
  • Classification of DC subtypes in patients with UC, Crohn's disease (CD), and non-IBD controls.
  • Analysis of DC prevalence in constipated and non-constipated UC patients.

Main Results:

  • Dolichocolon was common in UC patients, regardless of constipation status.
  • DC prevalence was higher in non-constipated UC patients compared to CD patients and controls.
  • Specific DC subtypes (Type 1 and Type 2) were associated with distinct UC disease distributions (proctitis/left-sided vs. extensive/pancolitis).

Conclusions:

  • Dolichocolon may be associated with varying UC phenotypes and influence disease extent independently of constipation.
  • These findings require cautious interpretation due to the study's cross-sectional design.
  • Longitudinal studies are necessary to confirm the observed associations.