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Murine Colitis Modeling using Dextran Sulfate Sodium (DSS)
Published on: January 20, 2010
Collagenous colitis and fecal stream diversion
1Department of Medicine, Orebro Medical Center Hospital, Sweden.
Gastroenterology
|August 1, 1995
Summary
Surgical fecal diversion, like ileostomy, effectively treated severe collagenous colitis (CC). Symptoms and collagen thickening resolved, but recurred upon intestinal reanastomosis, suggesting a luminal factor in CC pathogenesis.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Histopathology
Background:
- The etiology of collagenous colitis (CC) remains unknown.
- Limited treatment data exists, with surgical therapy previously unreported.
- This study investigates surgical intervention for refractory CC.
Purpose of the Study:
- To evaluate the efficacy of surgical fecal diversion in patients with medically unresponsive collagenous colitis.
- To assess the histopathological changes in the colonic subepithelial collagen layer following surgical intervention.
Main Methods:
- Nine female patients with severe, treatment-resistant collagenous colitis underwent surgical procedures.
- Fecal diversion was achieved via ileostomy (8 patients) or Hartmann procedure (1 patient).
- Histological assessment of the subepithelial collagen layer thickness was performed pre- and post-operatively.
Main Results:
- All patients experienced complete resolution of severe diarrhea post-diversion.
- The thickened subepithelial collagen layer significantly reduced from a median of 20 microns to 2 microns.
- Recurrence of symptoms and collagen thickening occurred after intestinal continuity restoration.
- Permanent fecal diversion (split ileostomy) resulted in sustained normalization of the collagen layer.
Conclusions:
- Fecal stream diversion induces clinical and histopathological remission in collagenous colitis.
- Recurrence post-ostomy closure suggests a critical role for luminal factors in CC pathogenesis.
- A split ileostomy may be a viable therapeutic option for older patients with medically resistant disease.
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