Collagenous colitis associated with chronic constipation

We present a case in which the classical histopathologic features associated with collagenous colitis were present throughout the colectomy specimen of a 69-year-old woman operated on for life-long intractable idiopathic constipation. This patient had never suffered from episodes of watery diarrhea. The reasons for this paradox are unclear, but suggest that a thickened collagen table and damaged surface epithelium may not be entirely specific pathologic findings marking the clinicopathological syndrome of collagenous colitis.