Short- and Long-Term Follow-Up of Treatment for Lymphocytic and Collagenous Colitis

Bonner, Gregory F.; Petras, Robert E.; Cheong, Denis M. O.; Grewal, Indira D.; Breno, Susan; Ruderman, William B.

doi:10.1097/00054725-200005000-00003

Cited by 20 publications

(37 citation statements)

References 13 publications

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“…The reported natural history of microscopic colitis is widely variable. Symptomatic remission after many years of follow‐up ranges from 60% to 93% in lymphocytic colitis 24, 29 and from 2% to 92% in collagenous colitis 16, 30–32 . One study reported spontaneous remission rates of 59% in lymphocytic colitis and 34% in collagenous colitis after 6 months of follow‐up, with an additional 25% and 40% respectively, showing ‘significant improvement.’ 33 By contrast, in the clinical trials reported to date, placebo response rates after 6–8 weeks were only 12–20% in collagenous colitis, 34–36 and 48% in lymphocytic colitis 37 .…”

Section: Clinical Featuresmentioning

confidence: 99%

Review article: microscopic colitis - lymphocytic, collagenous and ‘mast cell’ colitis

Yen¹,

Pardi²

2011

Alimentary Pharmacology &Amp; Therapeutics

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Aliment Pharmacol Ther 2011; 34: 21–32 Summary Background Microscopic colitis is a relatively common cause of chronic diarrhoea in predominantly older adults, traditionally termed lymphocytic colitis and collagenous colitis. Increased mast cells found in the colonic biopsies of some patients with chronic diarrhoea may represent a distinct type of microscopic colitis. Aim To provide an updated review of the epidemiology, diagnosis and treatment of microscopic colitis, and to discuss the role of mast cells in the gastrointestinal tract and their potential role in cases of functional diarrhoea. Method A MEDLINE literature search was performed to identify pertinent articles. Relevant clinical abstracts were also reviewed. Results Incidence rates of microscopic colitis (lymphocytic and collagenous colitis) have increased over time, to levels comparable with other forms of inflammatory bowel disease. The possibility of drug‐induced microscopic colitis and concomitant coeliac sprue are important considerations when evaluating these patients. There are few controlled treatment trials in microscopic colitis, with much of the data on treatment coming from retrospective studies. Mast cells have been implicated in functional bowel disorders, with increased mast cells possibly contributing to cases of otherwise unexplained chronic diarrhoea, although this concept requires further investigation. Conclusions In patients with microscopic colitis, a systematic approach to therapy often leads to satisfactory control of symptoms. The role of mast cells in chronic diarrhoea represents an evolving field, with the potential to offer alternative treatment pathways in patients with otherwise unexplained functional diarrhoea.

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Section: Clinical Featuresmentioning

confidence: 99%

Review article: microscopic colitis - lymphocytic, collagenous and ‘mast cell’ colitis

Yen¹,

Pardi²

2011

Alimentary Pharmacology &Amp; Therapeutics

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“…Fine et al ., in an abstracted report, reported bismuth subsalicylate to be effective in improving symptoms associated with this disorder 8 . Other investigators have used aminosalicylates or corticosteroids with various degrees of success 9 . The recurrence rate is high in patients who discontinue corticosteroids after an initial positive response.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis: budesonide treatment for collagenous colitis

Feyen

Wall

Finnerty

et al. 2004

Aliment Pharmacol Ther

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SUMMARYBackground: Collagenous colitis is typified by chronic watery diarrhoea and characteristic histological alterations of the colonic mucosa without endoscopic abnormalities. Budesonide, a corticosteroid with high first-pass metabolism has been examined in collagenous colitis, but studies to date have had small numbers, and relatively low statistical power. Aim: A meta-analysis of existing published trials was undertaken to evaluate the treatment effect of budesonide in collagenous colitis. Methods: All pertinent literature sources were searched for published reports in English of budesonide use in

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“…A placebo response rate of 12–20% and 48% has been reported in CC and LC, respectively, thus suggesting that LC has a milder course than CC and a greater tendency towards spontaneous remission . According to two studies with an average follow‐up of 3–4 years, CC shows high remission rates even without the need for specific maintenance treatment . In the case of LC, a benign course with resolution of the diarrhoea and normalisation of the histological characteristics have been described in 80% of the patients .…”

Section: Statements and Recommendationsmentioning

confidence: 99%

Current concepts on microscopic colitis: evidence‐based statements and recommendations of the Spanish Microscopic Colitis Group

Fernández‐Bañares

Casanova

Arguedas

et al. 2015

Aliment Pharmacol Ther

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Summary Background Microscopic colitis (MC) is an underdiagnosed inflammatory bowel disease. Aim To develop an evidence‐based clinical practice guide on MC current concepts. Methods Literature search was done on the Cochrane Library, EMBASE and MEDLINE electronic databases, which were consulted covering the period up until March 2015. Work groups were selected for each of the reviewed topics, with the purpose of drafting the initial statements and recommendations. They subsequently underwent a voting process based on the Delphi method. Each statement/recommendation was accompanied by the result of the vote the level of evidence, and discussion of the corresponding evidence. The grade of recommendation (GR) using the GRADE approach was established for diagnosis and treatment recommendations. Results Some key statements and recommendations are: advancing age increases the risk of developing MC, mainly in females. The symptoms of MC and IBS‐D may be similar. If MC is suspected, colonoscopy taking biopsies is mandatory. Treatment with oral budesonide is recommended to induce clinical remission in patients with MC. Oral mesalazine is not recommended in patients with collagenous colitis for the induction of clinical remission. The use of anti‐TNF‐alpha drugs (infliximab, adalimumab) is recommended for the induction of remission in severe cases of MC that fail to respond to corticosteroids or immunomodulators, as an alternative to colectomy. Conclusions This is the first consensus paper on MC based on GRADE methodology. This initiative may help physicians involved in care of these patients in taking decisions based on evidence.

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Short- and Long-Term Follow-Up of Treatment for Lymphocytic and Collagenous Colitis

Cited by 20 publications

References 13 publications

Review article: microscopic colitis - lymphocytic, collagenous and ‘mast cell’ colitis

Review article: microscopic colitis - lymphocytic, collagenous and ‘mast cell’ colitis

Meta‐analysis: budesonide treatment for collagenous colitis

Current concepts on microscopic colitis: evidence‐based statements and recommendations of the Spanish Microscopic Colitis Group

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