Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.

Abstract

Background-Data on collagenous colitis have been based on a limited number of patients. Aims-To obtain more information on this disease from a register set up at Orebro Medical Center Hospital. Patients and methods-Twenty five Swedish hospitals have contributed to this patient register, which comprises 163 histopathologically verified cases. Clinical data were retrospectively analysed. Results-Collagenous colitis followed a chronic intermittent course in most cases (85%) with a sudden onset in 42%. Symptoms were chronic watery diarrhoea, often nocturnal (27%), abdominal pain (41%), and weight loss (42%). Sixty six patients (40%) had one or more associated diseases. Routine laboratory data were mostly normal. The median age at diagnosis was 55 (range 16-86) years, but 25% of the patients were younger than 45 years. Seven patients died of unrelated diseases. The response rate for sulphasalazine was 59%, and 50% and 40% for mesalazine and olsalazine. Prednisolone was most effective with a response rate of 82%/ but the required dose was often high and the effect was not sustained after withdrawal. Antibiotics were efficient in 63%. Cholestyramine and loperamide had response rates of 59% and 71% respectively. Conclusions-Collagenous colitis follows a chronic continuous course. Symptoms can be socially disabling, but the disease does not seem to have a malignant potential. A plan for the treatment of a newly diagnosed patient with coliagenous colitis is proposed.

Th1 Pathway: The Missing Link Between Inflammatory Bowel Disease and Microscopic Colitis?

“…These figures are in agreement with two Swedish retrospective reports by Mellander et al [6] or Bohr et al [7] who reported that 2.1 and 1.8% of MC patients had concomitant or delayed IBD and MC diagnoses, respectively. Along the same line, five out of 790 IBD patients (0.6%) developed MC after the IBD diagnosis in the IBD Cohort of Uppsala Health Region (ICURE) study [8].…”

Microscopic Colitis with Granuloma Which Responded to Steroid Therapy

“…Although a female preponderance has been reported in MC, especially in collagenous colitis, (11)(12)(13)(14), recent reports show that this remains controversial (3). Zins et al reported no significant gender differences for collagenous colitis or lymphocytic colitis (15).…”

Evolution of ideas on microscopic colitis

“…На примере большой популяции из 163 пациентов с КК I. Bohr и соавт. [56] определили следующую частоту симптомов: ночная диарея (27%), снижение массы тела (42%), боли в животе (41%), усталость (21%) и метеоризм (12%).…”

“…В ретроспективных исследованиях показана эффективность ло-перамида в дозе от 2 до 16 мг/сут, однако стойкая клиническая ремиссия при его применении развивается редко [17,34,56].…”