What is collagenous colitis & lymphocytic colitis?

Collagenous colitis and lymphocytic colitis (often called microscopic colitis) are types of inflammatory bowel disease. These conditions are thought to be related to the other types of inflammatory bowel disease, but are different. In these diseases, during colonoscopy, there is little to no endoscopically visible changes noted.  However, changes of inflammation are seen only on biopsies taken from the normal appearing intestinal lining.

What are the symptoms of collagenous colitis and lymphocytic colitis?

The symptoms are the same for both collagenous colitis and lymphocytic colitis, including watery, non – bloody diarrhea.  The symptoms may come and go during ones life. 

What causes collagenous colitis & lymphocytic colitis?

There is no known cause for collagenous colitis and lymphocytic colitis.  Scientists believe that these may be due to autoimmune responses, or caused by bacteria and their toxins.   Factors that make collagenous colitis worse include NSAID type drugs, and ergot alkaloids.

Who gets collagenous colitis and lymphocytic colitis?

The most common age for diagnosis for collagenous colitis and lymphocytic colitis is 60 to 80 years old.  Collagenous colitis is diagnosed more often in women, while lymphocytic colitis equally impacts both men and women. 

How is collagenous colitis and lymphocytic colitis diagnosed?

The diagnosis of collagenous colitis or lymphocytic colitis is done through biopsies (tissue samples) taken during a colonoscopy or a flexible sigmoidoscopy, in a patient who has the symptoms even when they have a completely normal appearing colon. 

How is collagenous colitis and lymphocytic colitis treated?

The treatment for collagenous colitis and lymphocytic colitis depend on the symptoms and the severity.  The disease may also resolve itself.    The first course of treatment is usually the implementation of lifestyle changes, such as diet.  

If this is not effective, the following may be used:

• Anti-inflammatory medications, such as Mesalamine (Rowasa® or Canasa®) and sulfasalazine (Azulfidine®) to reduce swelling
• Steroids, such as budesonide (Entocort®) to control a sudden diarrhea attack
• Anti-diarrheal medications, such as Pepto Bismol, Lomotil or Imodium
• Bile acid sequenstrants such as cholestyramine and colestid
• Immunosuppressant agents, such as azathoprine (Imuran®) to reduce inflammation