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[Collagen colitis and lymphocytic (microscopic) colitis: different or common origin?]

P Netzer1, H Levkovits, A Zimmermann

  • 1Abt. für Gastroenterologie, Inselspital, Universitätsspital Bern.

Zeitschrift Fur Gastroenterologie
|February 12, 1998
PubMed
Summary

Collagenous colitis and lymphocytic colitis cause chronic watery diarrhea, diagnosed via biopsy. Treatment with mesalazine effectively resolved symptoms in two patients, suggesting a benign, treatable course for these microscopic colitis conditions.

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Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Collagenous colitis and lymphocytic colitis are chronic inflammatory colonic diseases presenting with chronic watery diarrhea.
  • Diagnosis relies on histological examination of colonic biopsies, with unknown pathogenesis possibly involving autoimmune factors or luminal irritants.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are a potential etiologic factor in collagenous colitis for some patients.

Observation:

  • Two cases of therapy-refractive chronic watery diarrhea were presented: a 70-year-old woman with collagenous colitis (diagnosed after 10+ years of symptoms) and a 30-year-old man with lymphocytic colitis (diagnosed after 6 months of symptoms).
  • Both patients were admitted to the hospital within a month of each other.
  • Histological examination confirmed collagenous colitis in the woman and lymphocytic colitis in the man.

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Findings:

  • Both collagenous colitis and lymphocytic colitis are characterized by chronic watery diarrhea and require histological diagnosis.
  • Mesalazine therapy led to symptom resolution within three weeks for both patients.
  • These conditions, while distinct entities, may represent different manifestations of microscopic colitis.

Implications:

  • Microscopic colitis syndromes, including collagenous and lymphocytic colitis, are often benign and treatable with 5-aminosalicylate (mesalazine) or corticosteroids.
  • Prompt diagnosis through histology and appropriate therapy can lead to clinical and histopathological resolution.
  • Further research into the pathogenesis of these conditions is warranted to identify potential triggers and refine treatment strategies.