A useful collagenous colitis registry

Abstract

Collagenous colitis is a rare and underdiagnosed disease causing watery diarrhoea up to 20 times a day in middle-aged women. Little is known of the disease because of the small number of series published. 1 Halaby IA Rantis PC Vernava AM Longo WE Collagenous colitis: pathogenesis and management. Dis Colon Rectum. 1996; 39: 573-578 Crossref PubMed Scopus (28) Google Scholar Bohr and colleagues' 2 Bohr J Tysk Eriksson S Abrahamson H Jäinerot Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut. 1996; 39: 846-851 Crossref PubMed Scopus (366) Google Scholar recent description of 163 cases from a registry to which 25 Swedish hospitals contribute provides useful additional information on the natural history and treatment of this disorder, which was first described by Lindstrom in 1976. 3 Lindstrom CG “Collagenous colitis” with watery diarrhoea—a new entity?. Pathol Eur. 1976; 11: 87-89 PubMed Google Scholar Its main features are summarised in the panel. Tabled 1 Prevalence Rare, about 6/1400 colitics Sex F:M 7.5–20:1 Age Sixth decade (rarely children) Symptoms Watery diarrhoea, abdominal pain Laboratory investigations Normal or mildly raised erythrocyte sedimentation rate Colonoscopy Usually normal Diagnosis Proximal colonic biopsy Histology Subepithelial collagen band; chronic inflammatory infiltrate Differential diagnosis Ulcerative colitis, infection, ischaemia, radiation, scleroderma, amyloid, Whipple's, laxatives, hyperthyroidism Disease associations Ulcerative colitis, Crohn's disease, coeliac disease, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, pernicious anaemia, myasthenia gravis, Hashimoto's disease Treatment Symptomatic, salazopyrin, mesalazine, mepacrine, metronidazole, cholestyramine, prednisolone Prognosis Chronic relapsing disease. Very rarely life threatening Aetiology ? Intraluminal agent; ? auto-immune; ? non-steroidal anti-inflammatory drugs Open table in a new tab