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Collagenous colitis associated with chronic constipation

C Leigh¹, A Elahmady, F A Mitros

¹Department of Internal Medicine, University of Iowa College of Medicine, Iowa City.

The American Journal of Surgical Pathology

|January 1, 1993

Summary

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Histopathologic features of collagenous colitis were found in a patient with chronic constipation, not diarrhea. This suggests these findings may not solely indicate collagenous colitis.

Area of Science:

Gastroenterology
Histopathology
Colorectal Surgery

Background:

Collagenous colitis is a condition characterized by a thickened subepithelial collagen layer in the colon.
It typically presents with chronic watery diarrhea.
Histopathologic confirmation is key for diagnosis.

Observation:

A 69-year-old woman underwent colectomy for severe, lifelong idiopathic constipation.
The colectomy specimen revealed classical histopathologic features of collagenous colitis throughout the colon.
The patient had no history of watery diarrhea.

Findings:

The presence of collagenous colitis histopathology in a patient with chronic constipation challenges typical clinical presentations.
This case highlights that thickened collagen tables and damaged surface epithelium may not be exclusive markers for the symptomatic presentation of collagenous colitis.

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Implications:

The clinicopathological correlation of collagenous colitis may be broader than previously understood.
Further research is needed to elucidate the mechanisms behind this presentation.
Diagnostic criteria may need re-evaluation to encompass varied clinical scenarios.