What are collagenous colitis and lymphocytic colitis?
Inflammatory bowel disease is the general name for diseases that
cause inflammation in the intestines, most often referring to Crohn's
disease and ulcerative colitis. Collagenous colitis and lymphocytic
colitis are two other types of bowel inflammation that affect the
colon. The colon is a tube-shaped organ that runs from the first part
of the large bowel to the rectum. Solid waste, or stool, moves through
the colon to be eliminated. Collagenous colitis and lymphocytic colitis
are not related to Crohn's disease or ulcerative colitis, which are
more severe forms of inflammatory bowel disease.
Collagenous colitis and lymphocytic colitis are also called
microscopic colitis. Microscopic colitis means there is no sign of
inflammation on the surface of the colon when viewed with a colonoscopy
or flexible sigmoidoscopy two tests that let a doctor look inside your
large intestine. Because the inflammation isn't visible, a biopsy is
necessary to make a diagnosis. A doctor performs a biopsy by removing a
small piece of tissue from the lining of the intestine during a
colonoscopy or flexible sigmoidoscopy.
What are the symptoms?
The symptoms of collagenous colitis and lymphocytic colitis are the
same, chronic, watery, non-bloody diarrhea. Abdominal pain or cramps may
also be present. People with collagenous colitis and lymphocytic
colitis may suffer from ongoing diarrhea while others have times when
they are symptom free.
What causes collagenous colitis and lymphocytic colitis?
Scientists are not sure what causes collagenous colitis or
lymphocytic colitis. Bacteria and their toxins, or a virus, may be
responsible for causing inflammation and damage to the colon. Some
scientists think that collagenous colitis and lymphocytic colitis may
result from an autoimmune response, which means that the body's immune
system destroys healthy cells for no known reason.
Who gets collagenous colitis and lymphocytic colitis?
Collagenous colitis is most often diagnosed in people between 60 and
80 years of age. However, some cases have been reported in adults
younger than 45 years and in children. Collagenous colitis is diagnosed
more often in women than men.
People with lymphocytic colitis are also generally diagnosed between
60 and 80 years of age. Both men and women are equally affected.
How are they diagnosed?
Some scientists think that collagenous colitis and lymphocytic
colitis are the same disease in different stages. The only way to
determine which form of colitis a person has is by performing a biopsy.
A diagnosis of collagenous colitis or lymphocytic colitis is made
after tissue samples taken during a colonoscopy or flexible
sigmoidoscopy are examined with a microscope.
Collagenous colitis is characterized by a larger-than-normal band of
protein called collagen inside the lining of the colon. The thickness
of the band varies; so several tissue samples from different areas of
the colon may need to be examined.
With lymphocytic colitis, tissue samples show an increase of white
blood cells, known as lymphocytes, between the cells that line the
colon. The collagen is not affected.
Treatment
Treatment for collagenous colitis and lymphocytic colitis varies
depending on the symptoms and severity of the case. The diseases have
been known to resolve on their own, although most people suffer from
ongoing or occasional diarrhea.
Lifestyle changes are usually tried first. Recommended changes
include reducing the amount of fat in the diet, eliminating foods that
contain caffeine and lactose, and avoiding over-the-counter pain
relievers such as ibuprofen or aspirin.
If lifestyle changes alone are not enough, medications can be used to help control symptoms.
Treatment
usually starts with prescription anti-inflammatory medications, such as
mesalamine (Rowasa or Canasa) and sulfasalazine (Azulfidine), in order
to reduce swelling.
Steroids, including budesonide
(Entocort) and prednisone are also used to reduce inflammation.
Steroids are usually only used to control a sudden attack of diarrhea.
Long-term use of steroids is avoided because of side effects such as
bone loss and high blood pressure.
Anti-diarrheal
medications such as bismuth subsalicylate (Pepto Bismol), diphenoxylate
atropine (Lomotil), and loperamide (Imodium) offer short-term relief.
Immunosuppressive agents such as azathioprine (Imuran) reduce the inflammation but are rarely needed.
For extreme cases of collagenous colitis and lymphocytic colitis
that have not responded to medication, surgery to remove all or part of
the colon may be necessary. However, surgery is rarely recommended.
Collagenous colitis and lymphocytic colitis do not increase a person's
risk of getting colon cancer.
Collagenous colitis and lymphocytic colitis do not increase a person's risk of getting colon cancer.
Reprinted from National Digestive Diseases Information Clearinghouse.
