Health-related quality of life is impaired in active collagenous colitis

Department of Gastroenterology and Endocrinology, Division of Gastroenterology and Hepatology, Faculty of Health Sciences, Linköping University Hospital, Linköping University, Sweden.
Digestive and Liver Disease (Impact Factor: 2.96). 02/2011; 43(2):102-9. DOI: 10.1016/j.dld.2010.06.004
Source: PubMed


The characteristic clinical symptoms of collagenous colitis are non-bloody diarrhoea, urgency and abdominal pain. Treatment is aimed at reducing the symptom burden and the disease impact on patients' health-related quality of life. The objective of this study was to analyse health-related quality of life in patients with collagenous colitis.
In a cross-sectional, postal HRQL survey, 116 patients with collagenous colitis at four Swedish hospitals completed four health-related quality of life questionnaires, two disease-specific (Inflammatory Bowel Disease Questionnaire and Rating Form of IBD Patient Concerns), and two generic (Short Form 36, SF-36, and Psychological General Well-Being, PGWB), and a one-week symptom diary. Demographic and disease-related data were collected. Results for the collagenous colitis population were compared with a background population controlled for age and gender (n = 8931).
Compared with a Swedish background population, patients with collagenous colitis scored significantly worse in all Short Form 36 dimensions (p < 0.01), except physical function. Patients with active disease scored worse health-related quality of life than patients in remission. Co-existing disease had an impact on health-related quality of life measured with the generic measures. Lower education level and shorter disease duration were associated with decreased well-being.
Health-related quality of life was impaired in patients with collagenous colitis compared with a background population. Disease activity is the most important factor associated with impairment of health-related quality of life. Patients in remission have a health-related quality of life similar to a background population.

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    • "However, there has been an increasing interest in this area. In a Swedish cross-sectional study, patients with active CC had impaired HRQoL compared with patients with inactive disease, and with a Swedish background population.134 The impact on HRQoL was independently and mainly associated with severity of clinical symptoms. "
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    ABSTRACT: Collagenous colitis and lymphocytic colitis, together constituting microscopic colitis, are common causes of chronic diarrhea. They are characterized clinically by chronic nonbloody diarrhea and a macroscopically normal colonic mucosa where characteristic histopathological findings are seen. Previously considered rare, they now have emerged as common disorders that need to be considered in the investigation of the patient with chronic diarrhea. The annual incidence of each disorder is five to ten per 100,000 inhabitants, with a peak incidence in 60- to 70-year-old individuals and a predominance of female patients in collagenous colitis. The etiology and pathophysiology are not well understood, and the current view suggests an uncontrolled mucosal immune reaction to various luminal agents in predisposed individuals. Clinical symptoms comprise chronic diarrhea, abdominal pain, fatigue, weight loss, and fecal incontinence that may impair the patient's health-related quality of life. An association is reported with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. The best-documented treatment, both short-term and long-term, is budesonide, which induces clinical remission in up to 80% of patients after 8 weeks' treatment. However, after successful budesonide therapy is ended, recurrence of clinical symptoms is common, and the best possible long-term management deserves further study. The long-term prognosis is good, and the risk of complications, including colonic cancer, is low. We present an update of the epidemiology, pathogenesis, diagnosis, and management of microscopic colitis.
    Full-text · Article · Aug 2014 · Clinical and Experimental Gastroenterology
    • "They also registered abdominal pain, number of bowel movements and watery and nocturnal stools during a week in a symptom diary. Results about smoking habits (active smoking was defined as daily smoking), clinical criteria for remission of CC as well as results for HRQOL and CC have been published elsewhere [25] [26] [27]. The patients' files were scrutinized retrospectively during 2012 for information about antibodies, duodenal biopsies and information about other associated autoimmune disorders. "
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    ABSTRACT: Background and aims: Collagenous colitis (CC) is associated with autoimmune disorders. The aim of the present study was to investigate the relationship between CC and autoimmune disorders in a Swedish multicenter study. Methods: Patients with CC answered questionnaires about demographic data and disease activity. The patient's files were scrutinized for information about autoimmune diseases. Results: A total number of 116 CC patients were included; 92 women, 24 men, median age 62 years (IQR 55-73). In total, 30.2% had one or more autoimmune disorder. Most common were celiac disease (CeD; 12.9%) and autoimmune thyroid disease (ATD, 10.3%), but they also had Sjögren's syndrome (3.4%), diabetes mellitus (1.7%) and conditions in skin and joints (6.0%). Patients with associated autoimmune disease had more often nocturnal stools. The majority of the patients with associated CeD or ATD got these diagnoses before the colitis diagnosis. Conclusion: Autoimmune disorders occurred in one-third of these patients, especially CeD. In classic inflammatory bowel disease (IBD), liver disease is described in contrast to CC where no cases occurred. Instead, CeD was prevalent, a condition not reported in classic IBD. Patients with an associated autoimmune disease had more symptoms. Patients with CC and CeD had an earlier onset of their colitis. The majority of the patients with both CC and CeD were smokers. Associated autoimmune disease should be contemplated in the follow-up of these patients.
    No preview · Article · Jun 2013 · Scandinavian Journal of Gastroenterology
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    • "Many patients may experience abdominal pain or weight loss, which are typically mild [17]. While often considered a benign illness, microscopic colitis is associated with a significantly diminished health-related quality of life, as diarrhoea with incontinence and decreased social functioning is a common problem [35]. In one study using the Gastrointestinal Quality of Life Index (GIQLI) score, patients with collagenous colitis reported reduced quality of life scores [36], which were lower than patients with anal fissures, severe chronic constipation, fecal incontinence [37] and gastroesophageal reflux disease requiring surgery [38]. "
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    ABSTRACT: Microscopic colitis includes the terms lymphocytic colitis and collagenous colitis, and is a common cause of chronic diarrhoea in older adults. The incidence of microscopic colitis has increased over time and has reached levels comparable to other forms of inflammatory bowel disease. In this chapter, an updated review on the epidemiology, diagnosis and treatment of microscopic colitis has been provided. There is limited data available about eosinophilic colitis, which is the least common of the eosinophilic GI disorders. It is important to rule out the secondary causes of colonic eosinophilia in patients with suspected eosinophilic colitis.
    Preview · Article · Oct 2012 · Best practice & research. Clinical gastroenterology
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