Collagenous colitis: Difference between revisions

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{{Infobox medical condition (new)
{{Short description|A type of inflammatory bowel disease}}
| name            = Collagenous colitis
{{Use dmy dates|date=October 2023}}
| image          = Collagenous colitis - high mag.jpg
| caption        = [[Micrograph]] of collagenous colitis. [[H&E stain]].
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| field          = [[Gastroenterology]]
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'''Collagenous colitis''' is an [[inflammatory bowel disease]] affecting the [[Colon (anatomy)|colon]] specifically with peak incidence in the 5th decade of life, affecting [[women]] more than [[men]].  Its clinical presentation involves watery diarrhea in the absence of rectal bleeding.  It is often classified under the umbrella entity [[microscopic colitis]], that it shares with a related condition, [[lymphocytic colitis]].<ref name=":0">{{Cite journal|last=Park|first=Tina|last2=Cave|first2=David|last3=Marshall|first3=Christopher|date=2015-08-07|title=Microscopic colitis: A review of etiology, treatment and refractory disease|journal=World Journal of Gastroenterology|volume=21|issue=29|pages=8804–8810|doi=10.3748/wjg.v21.i29.8804|issn=1007-9327|pmc=4528022|pmid=26269669}}</ref>


==Signs and symptoms==
'''Collagenous colitis''' is a form of [[inflammatory bowel disease]] characterized by chronic [[diarrhea]] and inflammation of the [[colon]]. It is a type of [[microscopic colitis]], which means that the inflammation is not visible during a colonoscopy and can only be seen under a microscope.
Microscopic colitis causes chronic watery diarrhea with greater than 10 bowel movements per day. Some patients report nocturnal diarrhea, abdominal pain, urgency, fecal incontinence, fatigue, dehydration and weight loss. Patients report a significantly diminished quality of life.<ref name=":0" /><ref name=":1">{{Cite journal|last=O’Toole|first=Aoibhlinn|date=2016-02-10|title=Optimal management of collagenous colitis: a review|journal=Clinical and Experimental Gastroenterology|volume=9|pages=31–39|doi=10.2147/CEG.S67233|issn=1178-7023|pmc=4754103|pmid=26929656}}</ref>


==Causes==
==Pathophysiology==
The cause of collagenous colitis is unknown.<ref name=":0" />
Collagenous colitis is distinguished by the presence of a thickened layer of [[collagen]] beneath the [[epithelium]] of the colon. This collagen layer is typically more than 10 micrometers thick. The exact cause of collagenous colitis is not well understood, but it is believed to involve an abnormal immune response in the [[gastrointestinal tract]].
 
==Symptoms==
The primary symptom of collagenous colitis is chronic, non-bloody [[watery diarrhea]]. Other symptoms may include [[abdominal pain]], [[bloating]], and [[weight loss]]. Some patients may also experience [[fatigue]] and [[dehydration]] due to the persistent diarrhea.


==Diagnosis==
==Diagnosis==
On [[colonoscopy]], the [[Mucous membrane|mucosa]] of the [[Colon (anatomy)|colon]] typically looks normal, but [[biopsy|biopsies]] of affected tissue usually show deposition of [[collagen]] in the [[lamina propria]], which is the area of [[connective tissue]] between [[Intestinal gland|colonic glands]].  Radiological tests, such as a [[barium enema]] are also typically normal.<ref name=":1" />
Diagnosis of collagenous colitis is typically made through a combination of clinical evaluation and [[colonoscopy]] with [[biopsy]]. During a colonoscopy, the colon may appear normal, but a biopsy will reveal the characteristic thickened collagen layer. [[Histopathology]] is essential for confirming the diagnosis.


==Treatment==
==Treatment==
First line treatment for collagenous colitis is the use of [[budesonide]], a steroid that works locally in the colon and is highly cleared by [[first pass effect]]. Other medications that can be used are the following:<ref name=":0" /><ref name=":1" />
Treatment for collagenous colitis often begins with lifestyle and dietary changes, such as avoiding [[caffeine]] and [[lactose]]. Medications may include [[antidiarrheal]] agents, [[anti-inflammatory]] drugs, and [[immunosuppressive]] therapies. In some cases, [[budesonide]], a corticosteroid, is used to reduce inflammation.
 
*[[Bismuth]] agents, including [[Pepto-Bismol]]
*[[5-aminosalicylic acid]]
*[[Immunosuppression|Immunosuppressant]]<nowiki/>s, including [[azathioprine]]
*[[infliximab]]
 
Pilot-scale studies have shown some evidence of possible benefit for both ''[[Boswellia serrata]]'' extract and specific strains of [[probiotics]] in the treatment of collagenous colitis, although larger sample sizes are needed to confirm the results.<ref>{{cite journal |vauthors=Madisch A, Miehlke S, Eichele O, Mrwa J, Bethke B, Kuhlisch E, Bästlein E, Wilhelms G, Morgner A, Wigginghaus B, Stolte M |title=''Boswellia serrata'' extract for the treatment of collagenous colitis. A double-blind, randomized, placebo-controlled, multicenter trial |journal=International Journal of Colorectal Disease |volume=22 |issue=12 |pages=1445–51 |date=Dec 2007 |pmid=17764013 |doi=10.1007/s00384-007-0364-1 }}</ref><ref>{{cite journal |vauthors=Wildt S, Munck LK, Vinter-Jensen L, Hanse BF, Nordgaard-Lassen I, Christensen S, Avnstroem S, Rasmussen SN, Rumessen JJ |title=Probiotic treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial with ''Lactobacillus acidophilus'' and ''Bifidobacterium animalis'' subsp. ''lactis'' |journal=Inflammatory Bowel Diseases |volume=12 |issue=5 |pages=395–401 |date=May 2006 |pmid=16670529 |doi=10.1097/01.MIB.0000218763.99334.49 }}</ref><ref>{{cite journal |vauthors=Tromm A, Niewerth U, Khoury M, Baestlein E, Wilhelms G, Schulze J, Stolte M |title=The probiotic ''E. coli'' strain Nissle 1917 for the treatment of collagenous colitis: first results of an open-label trial |journal=Zeitschrift für Gastroenterologie |volume=42 |issue=5 |pages=365–9 |date=May 2004 |pmid=15136935 |doi=10.1055/s-2004-812709 }}</ref>
 
==See also==
*[[Colitis]]
*[[Lymphocytic colitis]]
*[[Inflammatory bowel disease]]
*[[Ulcerative colitis]]


==References==
==Prognosis==
{{Reflist}}
The prognosis for collagenous colitis is generally good, with many patients responding well to treatment. However, the condition can be chronic and may require long-term management. Relapses are common, and ongoing monitoring by a healthcare provider is often necessary.


== External links ==
==Epidemiology==
{{Medical resources
Collagenous colitis is more common in [[middle-aged]] and [[elderly]] individuals, with a higher prevalence in [[women]] than in [[men]]. The exact prevalence is not well established, but it is considered a rare condition.
| DiseasesDB      = 2955
| ICD10          =
| ICD9            =
| ICDO            =
| OMIM            =
| MedlinePlus    =
| eMedicineSubj  = med
| eMedicineTopic  = 1351
| MeshID          = D046729
| ICD10CM        = {{ICD10CM|K52.831}}
}}


{{Digestive system diseases}}
==Related pages==
* [[Microscopic colitis]]
* [[Lymphocytic colitis]]
* [[Inflammatory bowel disease]]


[[Category:Colitis]]
[[Category:Inflammatory bowel disease]]
[[Category:Steroid-responsive inflammatory conditions]]
[[Category:Gastroenterology]]
{{dictionary-stub1}}
<gallery>
File:Collagenous_colitis_-_high_mag.jpg
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Revision as of 19:06, 22 March 2025

A type of inflammatory bowel disease



Collagenous colitis is a form of inflammatory bowel disease characterized by chronic diarrhea and inflammation of the colon. It is a type of microscopic colitis, which means that the inflammation is not visible during a colonoscopy and can only be seen under a microscope.

Pathophysiology

Collagenous colitis is distinguished by the presence of a thickened layer of collagen beneath the epithelium of the colon. This collagen layer is typically more than 10 micrometers thick. The exact cause of collagenous colitis is not well understood, but it is believed to involve an abnormal immune response in the gastrointestinal tract.

Symptoms

The primary symptom of collagenous colitis is chronic, non-bloody watery diarrhea. Other symptoms may include abdominal pain, bloating, and weight loss. Some patients may also experience fatigue and dehydration due to the persistent diarrhea.

Diagnosis

Diagnosis of collagenous colitis is typically made through a combination of clinical evaluation and colonoscopy with biopsy. During a colonoscopy, the colon may appear normal, but a biopsy will reveal the characteristic thickened collagen layer. Histopathology is essential for confirming the diagnosis.

Treatment

Treatment for collagenous colitis often begins with lifestyle and dietary changes, such as avoiding caffeine and lactose. Medications may include antidiarrheal agents, anti-inflammatory drugs, and immunosuppressive therapies. In some cases, budesonide, a corticosteroid, is used to reduce inflammation.

Prognosis

The prognosis for collagenous colitis is generally good, with many patients responding well to treatment. However, the condition can be chronic and may require long-term management. Relapses are common, and ongoing monitoring by a healthcare provider is often necessary.

Epidemiology

Collagenous colitis is more common in middle-aged and elderly individuals, with a higher prevalence in women than in men. The exact prevalence is not well established, but it is considered a rare condition.

Related pages

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