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Interventions for treating collagenous colitis.

N Chande1, J W D McDonald, J K MacDonald

  • 1LHSC--South Street Hospital, Mailbox 55, 375 South Street, London, Ontario, CANADA. nchande2@uwo.ca

The Cochrane Database of Systematic Reviews
|October 21, 2006
PubMed
Summary
This summary is machine-generated.

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See all related articles

Budesonide effectively treats collagenous colitis, improving clinical and histological outcomes. Other treatments like bismuth subsalicylate show weaker evidence, while prednisolone, Boswellia serrata, and probiotics require further investigation for collagenous colitis therapy.

Area of Science:

  • Gastroenterology
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Collagenous colitis is a recognized cause of chronic diarrhea.
  • Current treatment strategies for collagenous colitis often lack robust evidence.
  • This review aimed to identify therapies for collagenous colitis supported by randomized controlled trials.

Purpose of the Study:

  • To determine the efficacy of various treatments for clinically active collagenous colitis.
  • To synthesize evidence from randomized trials for collagenous colitis therapies.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (MEDLINE, PubMed, Cochrane Registers) from 1970 to June 2006.
  • Manual searches of references and abstracts from gastroenterological meetings supplemented database searches.

Related Experiment Videos

  • Seven randomized trials were identified, evaluating bismuth subsalicylate, Boswellia serrata, probiotics, prednisolone, and budesonide.

    • Main Results:

    • Budesonide demonstrated significant efficacy in three trials, with a pooled odds ratio of 12.32 for clinical response and a number needed to treat of 2.
    • Budesonide treatment led to significant histological improvement and enhanced quality of life.
    • Bismuth subsalicylate showed statistically significant clinical and histological improvement (p=0.003), while prednisolone showed a trend towards clinical response (p=0.064). Boswellia serrata and probiotics did not show significant clinical improvement compared to placebo.

    Conclusions:

    • Budesonide is an effective treatment for collagenous colitis, offering both clinical and histological benefits.
    • Evidence supporting bismuth subsalicylate is less robust, and its efficacy requires further confirmation.
    • The effectiveness of prednisolone, Boswellia serrata extract, and probiotics for collagenous colitis remains uncertain and warrants additional research.