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PubMed1985

Collagenous colitis.

A clinical and morphological description of "collagenous colitis" with reference to own cases is given. The disease presents with watery diarrhoea and abdominal pain in middle aged subjects, mostly women. Clinical and laboratory findings are normal. In colo-rectal biopsies there is a severe thickening of the so called "collagen table" in the superficial inter-cryptal lamina propria. Ultrastructural examination shows bandlike subepithelial collagenous fibrils of types I and III. The etiology of this lesion in the large bowel is hitherto unknown. The clinical course seems to be rather benign, requiring only symptomatic treatment.

Colitis↗
PubMed2001

[Collagenous colitis. A study of 11 cases].

BACKGROUND: Collagenous colitis (CC) is a rare large bowel inflammatory disorder. The aim of this retrospective study was to analyze extra-digestive manifestations of CC, associated systemic diseases, clinical course and response to therapeutic regimens. PATIENTS AND METHODS: Between 1989 and 1999, eleven patients were diagnosed as having CC, in two Departments of Internal Medicine and Gastroenterology, on the basis of usual criteria: chronic watery diarrhea, endoscopic examination showing normal findings and subepithelial collagen band thicker than 10 micrometer. RESULTS: Ten women and one man, age 39 to 88 years (mean: 66.6), had had their diarrhea for 1 to 240 months before diagnosis (mean: 48). Associated extra-digestive manifestations were: weight loss (3 cases out of 11), inflammatory arthralgia (4 cases), fever (2 cases), pelvispondylitis (2 cases), autoimmune thyroiditis (2 cases), and Sharp syndrome (1 cases). Laboratory abnormalities were: inflammatory syndrome (3 cases), anemia (5 cases), hypogammaglobulinemia (3 cases), and hypoalbuminemia (4 cases). Stool cultures and parasite examination were negative in all patients. Therapy used successively for CC until resolution of chronic diarrhea (uncontrolled with symptomatic treatment) was: sulfasalazine in 7 patients (beneficial (B) in 5 out of 7), 5-aminosalicylic acid in 6 (B: 2/6), corticosteroids in 2 (B: 2/2), azathioprine in 1 (B: 1/1). After a mean follow-up of 18 months (range: 1-72), resolution of CC was observed in 8 out of 11 patients. DISCUSSION: Mean characteristics of CC were: female predominance (91%), presence of extra-digestive manifestations (36%); mucosal inflammation with subepithelial collagen band and frequent association to rheumatic or autoimmune diseases suggest an immune basis for CC. Usefulness of systematic colon biopsies is underlined. Clinical course is often favorable with sulfasalazine and 5-aminosalicylate acid. Corticosteroids are rarely used.

Adult↗
PubMed1985

Collagenous colitis. A clinical, histological, and ultrastructural study.

Eleven patients with so-called collagenous colitis are described and the literature reviewed. The disease presents with persisting watery diarrhoea in middle-aged subjects, predominantly women. The fairly uniform clinical features of abdominal discomfort are suggestive of the irritable bowel syndrome. The morphological changes in colorectal biopsy specimens are diagnostic, showing an excessive intercryptal subepithelial collagen deposition throughout the large bowel. Associated hyperplasia, degeneration, and desquamation are seen in the intercryptal epithelial cells and a mild inflammatory response in the lamina propria. A comparable collagenization has not been demonstrated in other disorders, but otherwise the changes demonstrated histologically and ultrastructurally are of a quantitative nature. Collagenous colitis is unrelated to other diseases and the cause unknown. It has either a benign, continuous course or exacerbations and remissions. Loperamide relieved diarrhoea in five of six patients. The collagen deposition seems to be slowly progressive, but clinical and histopathological resolution may occasionally be seen.

Adult↗
PubMed1984

Sulfasalazine in treatment of collagenous colitis. Case report and review of the literature.

A patient is described with chronic colitis, watery diarrhea, and colonic mucosal subepithelial collagen deposition that resolved while being treated with sulfasalazine. The clinicopathologic features were consistent with collagenous colitis. Theoretically, the thickened collagen layer impairs water and electrolyte absorption, producing watery diarrhea. Such increased collagen is rarely observed in other inflammatory colon diseases and may represent a distinct morphologic reaction to various, yet undefined, injuries. Although the clinical course is benign, appropriate therapy for the debilitating symptoms is poorly understood. This report suggests that sulfasalazine may be helpful in some cases.

Chronic Disease↗
PubMed1993

Collagenous colitis associated with chronic constipation.

We present a case in which the classical histopathologic features associated with collagenous colitis were present throughout the colectomy specimen of a 69-year-old woman operated on for life-long intractable idiopathic constipation. This patient had never suffered from episodes of watery diarrhea. The reasons for this paradox are unclear, but suggest that a thickened collagen table and damaged surface epithelium may not be entirely specific pathologic findings marking the clinicopathological syndrome of collagenous colitis.

Aged↗