Collagenous colitis: a distinctive and potentially reversible disorder.

A Review of Collagenous Colitis

“…Support for this theory is found in reports showing a decrease in stool frequency coinciding with a decrease of the thickness of the subepithelial collagen layer (42,45,49,(72)(73)(74), either spontaneously or after treatment. Giardiello et al (75) observed that the thickening of the collagenous layer was most prominent between the crypts, where the main absorption of water and electrolytes takes place, whereas the crypt epithelium, where the secretion is believed to take place, is mostly unaffected.…”

“…Two cases of collagenous colitis with subepithelial collagen thickening of the duodenal and the gastric mucosa have also been reported (34,35), as has subepithelial collagen thickening in the ileum (36)(37)(38)(39). These cases of extracolonic localization of subepithelial collagen thickening are infrequent when compared with the many cases of histologically normal small intestine (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52).…”

“…The impact of faecal stream diversion in collagenous colitis indicates that a luminal agent might be involved in the aetiology of collagenous colitis. The effect of various antibiotics (7,45,49,54) and the sudden onset of the disease in a fairly substantial proportion of the patients (7) indicate that such an agent may be of microbiologic origin. Cholestyramine has the capacity to bind bacterial toxins, and a good clinical effect of cholestyramine has been reported in a patient with faecal cytotoxic activity (62).…”

Simultaneous Occurrence of Collagenous Colitis and Crohn’s Disease

“…The condition has been distinguished from other forms of in flammatory bowel disease [8] and is reported to respond to oral mepacrine [9]. The collag enous band was initially thought to interfere with colonic water and electrolyte absorp-1 1 The authors wish to thank Hilary Puckrin and Helen Rooker for typing the manuscript.…”

Collagenous Colitis: A Clinicopathological Review

“…However, one patient has been de scribed [6] as having benefited from a course of mepacrine hydrochloride with subsequent follow-up biopsy showing disappearance of the collagenous deposit. Another patient has been reported [12] as having been symptomfree for 1 year following treatment with co deine phosphate and mebeverine hydrochlo ride, the follow-up biopsy showing a substan tial decrease of the collagenous thickening.…”