Subepithelial Collagen Thickening in the Colon: Report on a Series of 23 Patients

Abstract

Background: To investigate the prevalence of collagenous colitis in patients presenting with diarrhoea. Methods: Descriptive retrospective study in consecutive patients under study because of chronic diarrhoea. Results: In a 4.5-year period 23 consecutive patients had histological signs of thickening of the subepithelial collagen band in the colon. There was a female predominance: 19 women versus 4 men, mean age 60 years (range 33–83). The stool frequency was 1–13 stools daily. Indicanuria was present in 9 patients. The patients were divided into 3 groups: those with definite collagenous colitis (n = 11; thickness of the collagen band of more than 10 µm); those with indefinite collagenous colitis (n = 8; thickness between 3 and 10 µm), and those with a collagen band between 1 and 3 µm (n = 4). During a mean follow-up of 20 months (range 13–36), 7 patients had waxing and waning episodes of diarrhoea, 11 showed spontaneous waning of complaints and a lower stool frequency. The 9 patients with indicanuria did well after a course of tetracyclin 250 mg t.i.d., but all cases relapsed during follow-up. Conclusion: It is concluded that thickening of the collagen band and collagenous colitis are not as unusual as usually thought.