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Collagenous colitis

Other Names for this Disease
  • Microscopic colitis, collagenous type
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What is collagenous colitis?

What are the signs and symptoms of collagenous colitis?

How might collagenous colitis be treated?

What is collagenous colitis?

Collagenous colitis is a type of inflammatory bowel disease that affects the colon. It is a form of microscopic colitis, which means that the inflammation is only visible when a biopsy is examined under a microscope; the inflammation cannot be seen or diagnosed from colonoscopy or sigmoidoscopy. Signs and symptoms may be ongoing or intermittent and may include chronic, watery, non-bloody diarrhea and abdominal pain or cramps.[1] The exact underlying cause is unknown but may relate to a bacteria, a virus, an autoimmune response, and/or a genetic predisposition.[2][1] Treatment for collagenous colitis varies depending on the symptoms and severity in each individual. In some cases, the condition resolves on its own.[1]
Last updated: 6/20/2013

What are the signs and symptoms of collagenous colitis?

All individuals with collagenous colitis experience chronic, watery, non-bloody diarrhea which is what typically prompts individuals to seek medical attention.[3][4] Onset of diarrhea may occur gradually over time or may be sudden and abrupt.[5] Episodes of diarrhea may be intermittent and can occur over weeks, months or years.[5]

Other signs and symptoms that commonly occur in affected individuals include abdominal pain or cramping; flatulence; bloating; and weight loss.[4][5] Incontinence, urgency, nausea, vomiting and fatigue have also been reported.[5]

Some individuals with collagenous colitis experience spontaneous remission even without treatment; however, relapses can occur.[5]
Last updated: 6/21/2013

How might collagenous colitis be treated?

Treatment for collagenous colitis varies depending on the symptoms and severity in each affected individual. In some cases the condition may resolve on its own (spontaneous remission), although most people continue to have ongoing or occasional diarrhea.[1]

Dietary changes are usually tried first to alleviate symptoms. These changes may include a reduced-fat diet, eliminating foods that contain caffeine and lactose, and avoiding over-the-counter pain relievers such as ibuprofen or aspirin. If these changes alone are not enough, medications can be used to help control symptoms.[1] However, the response rate to various types of medication reportedly varies.[3] Prescription anti-inflammatory medications such as mesalamine and sulfasalazine may help reduce swelling. Steroids including budesonide and prednisone can be used reduce inflammation, but they are usually only used to control sudden attacks of diarrhea. Long-term use of steroids is typically avoided because of unwanted side effects. Anti-diarrheal medications such as bismuth subsalicylate, diphenoxylate with atropine, and loperamide can offer short-term relief. Immunosuppressive agents such as azathioprine help to reduce inflammation but are rarely needed. In extreme cases where the condition does not respond to medications, surgery to remove all or part of the colon may be necessary. However, surgery is rarely recommended.[1]
Last updated: 6/21/2013

  1. Collagenous Colitis and Lymphocytic Colitis. National Digestive Diseases Information Clearinghouse (NDDIC). January 2006; Accessed 6/19/2013.
  2. Fernando Fernandez-Banares. Collagenous colitis. Orphanet. February 2005; Accessed 6/19/2013.
  3. Mahajan D, Goldblum JR, Xiao SY, Shen B, Liu X. Lymphocytic colitis and collagenous colitis: a review of clinicopathologic features and immunologic abnormalities. Adv Anat Pathol. January 2012; 19(1):28-38.
  4. Adriana Stoicescu, Gabriel Becheanu, Mona Dumbrava, Cristian Gheorghe and Mircea Diculescu. Mædica - a Journal of Clinical Medicine. 2012; 7(1):3-9. Accessed 6/20/2013.
  5. Colitis, collagenous. NORD. May 21, 2008; Accessed 6/21/2013.