[Collagenous colitis. Clinicopathological study of 18 cases].
ABSTRACT Collagenous colitis (CC) is an uncommon disease with a favorable prognosis. It is included in the group of chronic watery diarrheas.
To study epidemiological and clinical characteristics of CC, as well as its course and response to the treatment.
This is a descriptive, retrospective study of the endoscopic colon biopsies performed in Hospital de León during 5 years. Those biopsies that fulfilled the histological criteria of CC were selected.
A total of 18 cases with an incidence of 1.25/10(5) inhabitants/year was obtained. Mean age was 66.7 years. There was no difference between both genders. The period of time to diagnosis was long (10 months). A possible association with intake of some drugs, as non-steroidal antiinflammatory drugs (46%) and lansoprazole (42.8%), and smoking (41.6%), as well as autoimmune disease (30.7%) was found. There was a good response to the treatment with mesalazine in 2 of 3 patients who received this treatment. The clinical course was also favorable for the 2 patients treated with budesonide.
It is important to take multiple biopsies of the colon in order to diagnose CC when there is a case of chronic watery diarrhea even when the colonoscopy is normal. Certain drugs and autoimmune diseases may be involved in the etiology.
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ABSTRACT: The association between smoking and idiopathic inflammatory bowel disease is well known; smoking seems to have a diverse effect. Crohn's disease is associated with smoking, while ulcerative colitis is associated with non-smoking. Data on smoking in microscopic colitis of the collagenous type (CC) are lacking. The aim of this investigation was to study smoking habits in CC and to observe whether smoking had any impact on the course of the disease. 116 patients (92 women) with median age of 62 years (interquartile range 55-73) answered questionnaires covering demographic data, smoking habits and disease activity. As control group we used data from the general population in Sweden retrieved from Statistics Sweden, the central bureau for national socioeconomic information. Of the 116 CC patients, 37% were smokers compared with 17% of controls (p < 0.001, odds ratio (OR) 2.95). In the age group 16-44 years, 75% of CC patients were smokers compared with 15% of controls (p < 0.001, OR 16.54). All CC smoker patients started smoking before the onset of disease. Furthermore, smokers developed the disease earlier than non-smokers--at 42 years of age (median) compared with 56 years in non-smokers (p < 0.003). Although the proportion with active disease did not differ between smokers and non-smokers, there was a trend indicating that more smokers received active treatment (42% vs. 17%, p = 0.078). Smoking is a risk factor for CC. Smokers develop their disease more than 10 years earlier than non-smokers.Scandinavian Journal of Gastroenterology 08/2011; 46(11):1334-9. · 2.33 Impact Factor
Article: Microscopic colitis: an update.[Show abstract] [Hide abstract]
ABSTRACT: Microscopic colitis (MC) causes chronic diarrhea, abdominal cramping, nausea, and weight loss. Colonic mucosa appears normal on endoscopy; however, biopsies show abnormalities such as intraepithelial lymphocytosis in lymphocytic colitis, and a thickened subepithelial collagen band in collagenous colitis. Epidemiologic data demonstrates that MC is a more common cause of diarrhea than previously shown. Although the etiology of this condition is unclear, certain well-defined risk factors exist. Recently there has been more research on the pathophysiology of MC, and studies on treatment have demonstrated budesonide to be most effective, although other treatments also hold promise.Journal of clinical gastroenterology 02/2009; 43(4):293-6. · 2.21 Impact Factor
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ABSTRACT: Background The number of patients who require treatment with proton pump inhibitors (PPIs) is increasing in Japan. One of their adverse effects is diarrhea.Objectives We investigated the incidence of diarrhea caused by 3 different PPIs: lansoprazole, rabeprazole, and omeprazole.Methods Patients using PPIs for >1 month were enrolled. Enrolled patients recorded daily stool frequency, stool consistency using the Bristol Stool Scale Form, and impaired quality of life caused by diarrhea for 1 month. Their attending physicians described the types and dosages, and duration of PPI administration, as well as other necessary information.ResultsA total of 255 patients participated. Mean age of the patients was 70.7 years old. During the 1-month observation period, 3.5% of the patients complained of diarrhea. There was no significant difference for the incidence of diarrhea among the 3 types of PPIs. Furthermore, no correlations between diarrhea and length and dosage of PPI administration were found.Conclusions The incidence of diarrhea in patients receiving long-term therapy did not differ among 3 different PPIs. ClinicalTrials.gov identifier: UMIN ID 000005300.Current Therapeutic Research 06/2012; 73(3):112–120. · 0.45 Impact Factor