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Pathophysiology. The colonic mucosa is a self-renewing epithelium that is structured is a very tightly regulated balance between cell proliferation at the base of a crypt, maturation as colonocytes, migrate up the crypt, and extrusion of senescent and/or apoptotic cells from the upper crypt into the lumen.
Inflammation of the colon can lead to epithelial metaplasia, which reduces mucus production and renders the mucosa prone to bleeding, partially due to the loss of protective mucus. The submucosa, tunica muscularis, and serosa of the large intestine are similar to those of the small intestine, containing a mixture of lymphocytes, plasma cell, and macrophages, as well as capillaries, but lacking lacteals.