P1110 Collagenous colitis, clinical features, risk factors and treatment outcome: A large case series from the largest teaching Hospital in London, UK

Abstract

Abstract Background Microscopic colitis is a cause of chronic watery, non-bloody diarrhoea diagnosed mainly on histology after taking biopsy from macroscopically normal colonoscopy. Thereby mainly two subtypes can be identified: Lymphocytic and collagenous colitis. So far, no biomarkers for the diagnosis of microscopic colitis have been identified. Here, we looked at, risk factors and treatment outcome of collagenous colitis in large series of cases. Methods In this study, we analysed all cases of collagenous colitis diagnosed from 2018-2022 in the Northeast London from 5 different teaching hospitals. 104 cases were identified and their electronic health record from hospital and from the primary care physicians (GP) were manually reviewed. Results In this cohort, 24% male, 76% female with ratio of (1:3), with mean age of 65 years. Forty percent were active or ex-smoker. PPI uses were associated with in 81% cases. While NSAIDS and statin were associated in 56% and 49% cases respectively. We also found that SSRI use were noted about 31% cases. Painless watery diarrhoea was the main cause for referral in 90% of cases, while complaint of abdominal pain noted in only 39% cases. Thirty-five (35%) cases noted to have history of weight loss. Forty-eight (48%) patients received treatment with Budesonide, 46% treated with loperamide, 5% with Immunomodulator or Biologics and 1% Bismuth Subsalicylates respectively. Other autoimmune disease were associated in 6% cases and 2% cases were associated with Coeliac disease. in Nineteen (19%) of cases symptoms improved immediately after stopping above associated drugs without any specific therapy. Twenty-five (25%) percent relapses 6 months after stopping of therapy. Patients present with abdominal pain, and arthralgia were significantly (p<0.001) higher risk of relapsing compared to patients with other symptoms. Conclusion In this large series of collagenous colitis, we found that in addition to associated drug use is not only risk, patient presents with abdominal pain and arthralgia have higher risk of relapse, after stopping of therapy of collagenous colitis . Further studies are needed to identify biomarker of this frustrating disease which has significant impact on patients of quality of life.