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|Classification and external resources|
Collagenous colitis is an inflammatory bowel disease affecting the colon specifically with peak incidence in the 5th decade of life, affecting women more than men. Its clinical presentation involves watery diarrhea, usually in the absence of rectal bleeding. It is often classified under the umbrella entity microscopic colitis, along with a related condition, lymphocytic colitis.
Signs and symptoms
Microscopic colitis causes watery intermittent diarrhea with greater than 10 bowel movements per day. Some patients report nocturnal diarrhea, abdominal pain, dehydration and weight loss. Rare complications may include mucosal atrophy with long standing collagenous colitis. Though this is a mild condition, colitis patients report a significantly diminished quality of life.
The exact cause of collagenous colitis is unknown.
An association between collagenous colitis and celiac disease has been reported, but there is no evidence that dietary restrictions used in celiac disease management are of benefit in collagenous colitis therapy. Between 20-60% of patients with collagenous colitis have been reported as having one or more autoimmune disorders including rheumatoid arthritis and thyroid disease.
There have also been reports of an association between collagenous colitis and lymphoma.
On colonoscopy, the mucosa of the colon typically looks normal, but biopsies of affected tissue usually show deposition of collagen in the lamina propria, which is the area of connective tissue between colonic glands. Radiological tests, such as a barium enema are typically normal.
Treatment of collagenous colitis is often challenging, and many agents have been used therapeutically:
- Bismuth agents, including Pepto-Bismol
- 5-aminosalicylic acid
- Immunosuppressants, including azathioprine
Pilot investigational studies have shown some evidence of possible benefit for both Boswellia serrata extract and specific strains of probiotics in the treatment of collegenous colitis, although larger sample sizes are needed to confirm the results.
- Madisch A, Miehlke S, Eichele O, Mrwa J, Bethke B, Kuhlisch E, Bästlein E, Wilhelms G, Morgner A, Wigginghaus B, Stolte M. (Dec 2007). "Boswellia serrata extract for the treatment of collagenous colitis. A double-blind, randomized, placebo-controlled, multicenter trial.". Int J Colorectal Dis. (22(12):2): 1445–51. doi:10.1007/s00384-007-0364-1. PMID 17764013.
- Wildt S, Munck LK, Vinter-Jensen L, Hanse BF, Nordgaard-Lassen I, Christensen S, Avnstroem S, Rasmussen SN, Rumessen JJ. (May 2006). "Probiotic treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial with Lactobacillus acidophilus and Bifidobacterium animalis subsp. Lactis.". Inflamm Bowel Dis. (12(5)): 395–401. doi:10.1097/01.MIB.0000218763.99334.49. PMID 16670529.
- Tromm A, Niewerth U, Khoury M, Baestlein E, Wilhelms G, Schulze J, Stolte M. (May 2004). "The probiotic E. coli strain Nissle 1917 for the treatment of collagenous colitis: first results of an open-label trial.". Z Gastroenterol. (42(5)): 365–9. doi:10.1055/s-2004-812709. PMID 15136935.
- Chande N, Driman DK, Reynolds RP (March 2005). "Collagenous colitis and lymphocytic colitis: patient characteristics and clinical presentation". Scand. J. Gastroenterol. 40 (3): 343–7. doi:10.1080/00365520510011623. PMID 15932175.
- Yen E. F., Pardi D. S. (May 2011). "Microscopic Colitis – Lymphocytic, Collagenous and ‘Mast Cell’ Colitis". Alimentary Pharmacology & Therapeutics 34 (1): 21–32. doi:10.1111/j.1365-2036.2011.04686.x.
- Majores Michael, Wunsch Steffen, Blume Bernd, Fischer Hans-Peter, and Reichel Christoph (October 2011). Mucosal Atrophy in Collagenous Colitis: A Case Report 11 (114). doi:10.1186/1471-230X-11-114.
- Milman Nataliya, Kraa Gunnar (2010). "NSAID-induced Collagenous Colitis". The Journal of Rheumatology 37 (11): 2432–243. doi:10.3899/jrheum.100573.