Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.
BACKGROUND
Data on collagenous colitis have been based on a limited number of patients.


OBJECTIVE
To obtain more information on this disease from a register set up at Orebro Medical Center Hospital.


METHODS
Twenty five Swedish hospitals have contributed to this patient register, which comprises 163 histopathologically verified cases. Clinical data were retrospectively analysed.


RESULTS
Collagenous colitis followed a chronic intermittent course in most cases (85%) with a sudden onset in 42%. Symptoms were chronic watery diarrhoea, often nocturnal (27%), abdominal pain (41%), and weight loss (42%). Sixty six patients (40%) had one or more associated diseases. Routine laboratory data were mostly normal. The median age at diagnosis was 55 (range 16-86) years, but 25% of the patients were younger than 45 years. Seven patients died of unrelated diseases. The response rate for sulphasalazine was 59%, and 50% and 40% for mesalazine and olsalazine. Prednisolone was most effective with a response rate of 82%, but the required dose was often high and the effect was not sustained after withdrawal. Antibiotics were efficient in 63%. Cholestyramine and loperamide had response rates of 59% and 71% respectively.


CONCLUSIONS
Collagenous colitis follows a chronic continuous course. Symptoms can be socially disabling, but the disease does not seem to have a malignant potential. A plan for the treatment of a newly diagnosed patient with collagenous colitis is proposed.
Bohr
J
J
Department of Medicine, Orebro Medical Center Hospital, Sweden.
Tysk
C
C
Eriksson
S
S
Abrahamsson
H
H
Järnerot
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000930:Antidiarrheals; D002792:Cholestyramine Resin / Q000627:therapeutic use; D002908:Chronic Disease; D003092:Colitis / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D003094:Collagen / Q000032:analysis; D003106:Colon / Q000737:chemistry / Q000473:pathology; D003967:Diarrhea / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008139:Loperamide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000627:therapeutic use; D013548:Sweden
D000893:Anti-Inflammatory Agents; D000924:Anticholesteremic Agents; D000930:Antidiarrheals; D002792:Cholestyramine Resin; D012460:Sulfasalazine; D008139:Loperamide; D003094:Collagen; D011239:Prednisolone