Collagenous colitis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Collagenous colitis
Micrograph of collagenous colitis, showing the characteristic thickened subepithelial collagen band. H&E stain.
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Chronic diarrhea, abdominal pain, weight loss
Complications	Dehydration, electrolyte imbalance
Onset	Typically in adulthood
Duration	Chronic
Types	N/A
Causes	Unknown, possibly autoimmune
Risks	Smoking, use of NSAIDs, PPIs
Diagnosis	Colonoscopy with biopsy
Differential diagnosis	Ulcerative colitis, Crohn's disease, irritable bowel syndrome
Prevention	N/A
Treatment	Budesonide, loperamide, bismuth subsalicylate
Medication	N/A
Prognosis	Generally good with treatment
Frequency	10 per 100,000 people per year
Deaths	N/A

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.

See also

• Microscopic colitis
• Lymphocytic colitis
• Inflammatory bowel disease