Collagenous colitis: Description of a single centre series of 83 patients

Introduction: Collagenous colitis can be the cause of chronic diarrhoea. Aim: Assess the prevalence of collagenous colitis in a single centre. Patients: All records of patients with diarrhoea in whom histological examination showed collagenous colitis, were retrieved. Demographic data, clinical presentation, associated diseases and treatment were studied. Results: In a period of 15 years 83 patients were identified with collagenous colitis. These were 16 men and 67 women, mean age 60 years (range 20-87) at time of diagnosis. Thirty four patients (38%) complained of mushy stools and 49 (62%) of watery diarrhoea. Eight patients had rectal bleeding. Mucous discharge was noted by 18 patients. There was no weight loss in 55 patients. Six patients complained of loss of appetite, 9 had nausea, and 2 complained of vomitus. A macroscopically normal colon was present in 63 patients. Associated diseases, like celiac disease and hypothyroidism, only were seen in women. Twenty eight patients did not receive any treatment, ten patients received mesalazine. One patient was treated with steroids. Fourteen patients were treated for accompanying bacterial overgrowth. Fourteen patients used loperamide. Budesonide was applied with success in 17 patients. During follow-up 58 patients had no complaints anymore, 21 had mild diarrhoea, 3 moderate, while it was unknown in one patient. Conclusion: Collagenous colitis has a higher prevalence as usually reported. There is an association with autoimmune disorders and dysbacteriosis. (C) 2009 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.