Collagenous colitis is an uncommon type of inflammatory bowel disease (IBD), usually less severe than Crohn's disease or ulcerative colitis. It is very similar to lymphocytic colitis, and these two types of IBD are called microscopic colitis by the medical profession because diagnosis is confirmed by microscopic examination of biopsy tissue. Diagnosis of collagenous colitis is made when the biopsy shows increased thickness of the connective tissue (collagen) inside the colon lining.
The main symptom of collagenous colitis is chronic diarrhoea. This diarrhoea may continue daily or be intermittent. It can occur suddenly and cause incontinence. People with collagenous colitis may have 20 or 30 bowel movements a day, but most have four to nine, as noted by the Mayo Clinic. Additional symptoms may include abdominal cramping, bloating and nausea. The diarrhoea may cause the patient to become dehydrated.
According to the Mayo Clinic, collagenous colitis is more common in older adults and is also seen more often in women than in men. The cause has not been identified. Some researchers believe collagenous colitis is caused by a bacteria or virus. It also may be an autoimmune disorder. Many people with collagenous colitis have one or more other autoimmune conditions, such as diabetes, rheumatoid arthritis or thyroid disorders.
Medications Linked to Occurrence
Certain medications are linked to collagenous colitis flare-ups. Patients should not take anti-inflammatory non-steroidal drugs (NSAIDs) such as aspirin and ibuprofen. Acetaminophen is an acceptable alternative. Other medications associated with collagenous colitis symptoms include lansoprazole (Prevacid) and ranitidine (Zantac), both used to treat heartburn and gastro-oseophageal reflux disease (GERD); sertraline (Zoloft), a selective serotonin reuptake inhibitor used to treat depression and anxiety; the anti-platelet drug ticlopidine (Ticlid) and the diabetes medication acarbose (Precose).
According to the Mayo Clinic, many collagenous colitis cases clear up within several weeks with no treatment. Diet changes can help. The Clinic recommends eliminating alcohol and reducing intake of fatty, fried and spicy foods. Caffeine and lactose-containing foods (dairy products) should be avoided because they stimulate fluid secretion in the colon. However, eating yoghurt or adding a probiotic (healthy bacteria) supplement can be beneficial. People with collagenous colitis should avoid eating foods that cause gas, such as beans, cabbage and cauliflower, and any other foods that give them trouble.
If diet changes are not effective, physicians often recommend taking anti-diarrhoea medicines such as loperamide (Imodium) or a bismuth solution such as Pepto-Bismol. More serious and prolonged cases of collagenous colitis may require corticosteroid treatment or immunosuppressive drugs. In rare cases, surgery may be needed to remove the inflamed parts of the colon.