Interventions for treating collagenous colitis

Chande, Nilesh; McDonald, John W.D.; MacDonald, John K

doi:10.1002/14651858.cd003575.pub5

Cited by 32 publications

(25 citation statements)

References 89 publications

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“…A total of 80 patients, who had responded to openlabel budesonide, were randomized to budesonide 6 mg/d or placebo for 6 mo. Clinical response was maintained in 33/40 (83%) patients who received budesonide compared to 11/40 (28%) patients who [92] [94] . However, 6 mo maintenance therapy did not alter the subsequent course, as the relapse risk after withdrawal of 24 wk maintenance treatment was similar to that observed after 6 wk induction therapy, and the median time to relapse was equal in the two groups (39 d versus 38 d) [97] .…”

Section: Therapy and Prognosismentioning

confidence: 97%

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Diagnosis and management of microscopic colitis

Tysk¹,

Bohr²,

Nyhlin³

et al. 2008

WJG

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Microscopic colitis, comprising collagenous and lymphocytic colitis, is characterized clinically by chronic watery diarrhea, and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100 000 inhabitants, with a peak incidence in 60-70-year-old individuals and a noticeable female predominance for collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue and fecal incontinence are common symptoms, which impair the health-related quality of life of the patient. There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented shortterm treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.

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Section: Therapy and Prognosismentioning

confidence: 97%

“…In a Cochrane metaanalysis, the pooled odds ratio for clinical response with budesonide compared to placebo was 12.32 (95% CI 5. 53-27.46), and the number needed to treat was two patients [94] . In a placebo-controlled trial including 41 patients, budesonide treatment was effective also in LC [95] .…”

Section: Therapy and Prognosismentioning

confidence: 99%

Diagnosis and management of microscopic colitis

Tysk¹,

Bohr²,

Nyhlin³

et al. 2008

WJG

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“…No established treatments have yet been defined for PLE associated with collag enous colitis [12] . Corticosteroids are occasionally used for the treatment of collagenous colitis and some studies have shown that prednisolone treatment is ineffective [13] and budesonide is effective for collagenous colitis without PLE [14,15] .…”

Section: Discussionmentioning

confidence: 99%

A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone

Sano

Yamagami²,

Tanaka³

et al. 2008

WJG

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A 76-year-old woman with a 5-mo history of recurrent diarrhea and generalized edema was admitted to our hospital. Colonoscopy revealed edematous mucosa, and histopathological examination was compatible with collagenous colitis. Protein leakage from the colon, particularly in the ascending portion, was identified on 99mTc-human serum albumin scintigraphy. Collagenous colitis associated with protein-losing enteropathy (PLE) without small bowel disease was diagnosed. Prednisolone treatment ameliorated diarrhea and hypoproteinemia. Collagenous colitis should be included in the differential diagnosis of chronic diarrhea with hypoproteinemia for appropriate management.

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“…Bismuth subsalicylate was effective in MC in a small, randomized, placebo-controlled trial [Fine and Lee, 1998]. Aminosalicylates have, in uncontrolled or retrospective studies, had a moderate to good effect in MC [Pardi et al 2002;Chande et al 2008]. The experience of other immunosuppressive therapies are gathered in some systematic reviews, based on retrospective studies and case reports [Riddell et al 2007;Münch et al 2012].…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

New insights and challenges in microscopic colitis

Ohlsson

2014

Therap Adv Gastroenterol

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Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with the intestinal lumen. Furthermore, some patients with a microscopic inflammation in their colonic mucosa have no symptoms, or are suffering from constipation or abdominal pain, rather than diarrhea. Recently, a discussion was initiated calling into question the overdiagnosing of symptoms and pointing out the danger of exacerbating people's perception of their ailments, of weakening their eligibility in health insurance, of overprescription of drugs, and thus the increasing cost to the society of health care. In the light of this discussion, this review will highlight histopathological and clinical features of MC, and discuss the diagnosis and management of this disease. Perhaps, the intestinal mucosa has no other mode by which to react than an inflammatory response, irrespective of the presence or absence of autoimmunity. Thus, to better identify and classify subgroups of MC, and to clarify and correctly handle the inflammatory changes, this field of research stands to benefit from a review of the results and experience gained to date.

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Interventions for treating collagenous colitis

Cited by 32 publications

References 89 publications

Diagnosis and management of microscopic colitis

Diagnosis and management of microscopic colitis

A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone

New insights and challenges in microscopic colitis

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